Simple Procedure Prevents Bladder Problems after Uterine Prolapse Surgery

A nationwide, federally funded study involving 322 women having surgery for uterine prolapse showed conclusively that future bladder problems can be prevented with four additional stitches.

Uterine prolapse occurs when the uterus sags into the birth canal and causes pain. Frequent childbirths are generally a contributing factor. About 200,000 women have this condition corrected surgically each year.

The surgery itself can lead to bladder problems unless a second step, called the Burch procedure, is added. This procedure involves placing four permanent stitches (from the vagina to a pelvic ligament), forming a “hammock” that keeps urinary control muscle supported.


Women in the group that did not receive the extra stitches developed bladder control problems with greater frequency than those who did. Also known as “stress incontinence,” urine can leak when a woman coughs, sneezes or laughs hard.

The study showed that only 6% of women given the Burch procedure during uterine prolapse surgery developed urinary control symptoms three months later. Of those who didn’t receive the additional four stitches, 25% developed bothersome and embarrassing stress incontinence.

Because the benefits of the Burch procedure were so obvious, the study was stopped early. The technique was developed in the 1960s by Dr. John Burch, a Tennessee obstetrician. Other methods are also used to treat or prevent urinary leakage, but the study did not examine them.

This study demonstrated for the first time that an operation can actually prevent stress incontinence. Principal investigator Dr. Linda Brubaker of Loyola University pointed out that study findings are a big step forward in providing better solutions for these common women’s health problems.

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