I had a bladder suspension about 11 years ago. The doctor performed a Birch procedure (I don't know what that is). I had a difficult post op recovery and there was a question if the surgery would be successful. Once recovered, I had very few problems and the leaking was almost nil. I have two questions at this time. 1) What is a Birch procedure vs. other ones, and 2) The past 3 days I've been having alot of pelvic pain with shooting pains to the tailbone area. It seems to be relieved somewhat after voiding. Also, I have now started to leak a little. Could this be a bladder infection? I have no burning upon urination or frequent urges. I also have no female reproductive organs left, so I can rule that out. The doctor, at that time, said I would probably not have typical symptoms if I were to get a UTI and I don't remember why or what to look for, I've been fortunate to not have had a UTI since before the surgery. This all took place at a military base overseas so there's no option of a follow-up with him. Any insight you have would be greatly appreciated. Thank you in advance for your consideration. -------------------------------------------------------------------
Dear DJ,
The Burch procedure is one of many operations that can be performed for urinary incontinence. It is often successful (80%)and involves performing a retropubic suspension of the perivaginal facsia to Cooper’s ligament. This means that an abdominal incision is made which allows the surgeon to correct the defect from the inside. The fixation of the suspending sutures to Cooper’s ligament has led to the long duration of this procedure and if done properly you should expect good results.
Today, we have a number of vaginal operations that involve a sling procedure under the vaginal mucosa. These procedures still use the suspension approach however, they are fixed to the abdominal wall as opposed to Cooper’s ligament. I think either of these operations can be used successfully, it merely depends on the urologist’s experience.
To determine if your new leak is associated with a urinary tract infection, a simple urinalysis could answer your question. If there are still questions at that point in time a full urodynamic evaluation could be performed if your doctor felt is was necessary. It sounds like you haven’t been seen by a urologist at least in a few years. You might ask your family doctor if he or she thought this was necessary.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568). Sincerely,
HFHS M.D.-AK
KEYWORD: Incontinence
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