Retro pubic Urethropexy or Sling or Burch colposuspension; surgical procedure скачать в хорошем качестве

Retro pubic Urethropexy or Sling or Burch colposuspension; surgical procedure

Retropubic urethropexy is a surgical procedure used to treat stress urinary incontinence (SUI) in women by repositioning and securing the urethra and bladder neck to restore continence. The two main techniques are the Burch colposuspension and the Marshall-Marchetti-Krantz (MMK) procedure. 🧬 What Is Retropubic Urethropexy? It involves lifting and anchoring the urethra and bladder neck to the retropubic tissues (behind the pubic bone). The goal is to restore the urethrovesical angle, improving resistance to pressure changes during activities like coughing or sneezing. 🩺 Indications Stress urinary incontinence due to urethral hypermobility. Often chosen when mid-urethral sling procedures are contraindicated or have failed. Can be performed alongside other pelvic surgeries, such as hysterectomy. 🔧 Surgical Techniques 1. Burch Colposuspension Sutures are placed in the paravaginal tissues and anchored to the Cooper’s ligament. Avoids direct fixation to the pubic bone. Considered the gold standard for retropubic urethropexy. 2. Marshall-Marchetti-Krantz (MMK) Procedure Sutures are placed in the periurethral tissues and attached directly to the pubic symphysis. Less commonly used due to higher risk of osteitis pubis. ✅ Benefits High success rates (70–90%) for properly selected patients. Durable long-term outcomes. Can be done via open or laparoscopic approach. ⚠️ Risks and Complications Bladder injury or perforation Urinary retention Pelvic pain Osteitis pubis (especially with MMK) #Perineum