Urethral Suspension—Transvaginal Suspensions
Urethral suspension is a surgery to correct stress incontinence in women.
Female Bladder and Urethra
Reasons for Procedure
The goal of this surgery is to place the urethra and bladder back into the correct position. This will stop the uncontrolled leaking of urine.
Complications are rare, but no procedure is completely free of risk. If you are planning to have a urethral suspension, your doctor will review a list of possible complications, which may include:
- Reactions to anesthesia
- Inability to urinate
- Continued incontinence or recurrence of the problem
- Damage to other nearby organs or blood vessels
- Pain, such as during sexual intercourse
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
- Chronic disease such as diabetes or obesity
What to Expect
Prior to Procedure
Your doctor will try to find out why you are leaking urine through:
- Medical history—information about medications, illnesses, number of pregnancies, and previous surgeries; pattern of leaking and how it is affecting your life
- Urine sample—to look for the presence of infection or other problems
- Physical exam—includes a rectal and vaginal exam
Additional testing may be ordered to evaluate bladder function and urine flow, such as:
- Urodynamic testing (urine flow studies)—a temporary catheter is placed to study bladder function
- Cystoscopy —a procedure done to view the inside of the bladder
Leading up to surgery:
- Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
- Arrange for a ride home from the hospital.
- Do not eat or drink anything after midnight the night before.
Description of Procedure
This procedure is done through the vagina. There are no visible cuts made in the skin. Special surgical tools will be passed up through the vagina. These tools will be used to place sutures near the bottom of the bladder. The threads will then be tied to the abdominal wall or the pelvic bone. The thread will pull the bladder back into its normal position. The threads will be left in place to continue to support the bladder.
Immediately After Procedure
After surgery, you will be monitored in a recovery room. You will most likely have a catheter in place to drain your urine.
How Much Will It Hurt?
Anesthesia will block pain during the surgery. After surgery, you may experience some pain or soreness. You will be given pain medication to relieve the discomfort.
At the Hospital
At first, your urine may look bloody. This will resolve over time.
When you are able to empty your bladder completely, the catheter will be removed. You may be asked to get up and walk around.
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
- Washing their hands
- Wearing gloves or masks
There are also steps you can take to reduce your chances of infection such as:
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
Call Your Doctor
After you leave the hospital, contact your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Pain that you cannot control with the medicines you have been given
- Cough, shortness of breath, or chest pain
- Severe nausea or vomiting
- Trouble urinating
- Pain, burning, urgency, or frequency while urinating
If you think you have an emergency, call for emergency medical services right away
National Kidney and Urologic Diseases Information Clearinghouse
Urology Care Foundation
Canadian Continence Foundation
Canadian Urological Association
Incontinence. American Urological Association Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=143. Updated March 2013. Accessed October 28, 2014.
Surgical mesh. US Food and Drug Administration website. Available at: http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm142636.htm. Updated October 6, 2014. Accessed October 28, 2014.
Surgical treatment for female stress urinary incontinence. National Association for Continence website. Available at: http://www.nafc.org/bladder-bowel-health/types-of-incontinence/stress-incontinence/surgical-treatment-for-female-stress-urinary-incontinence. Accessed October 28, 2014.
Townsend MK, Danforth KN, et al. Physical activity and incident urinary incontinence in middle-aged women. J Urol. 2008;179:1012-1016; discussion 1016-1017.
Urinary incontinence. American Association of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/urinary-incontinence.html. Updated April 2014. Accessed October 28, 2014.
6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Last reviewed December 2014 by Adrienne Carmack, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.