The Burch procedure is a surgical procedure that is done to correct stress urinary incontinence. Stress urinary incontinence is more common in women and can occur after childbirth. Small amounts of urine can escape from the bladder during the simple activities of laughing, sneezing, or coughing. If stress incontinence interferes with quality of life, the patient may want to consider the Burch procedure.
Several risk factors can lead to symptoms of urinary incontinence. Birth of a child through the vaginal canal can lead to compression of the urethra, the tube that carries urine out of the bladder. The muscles around the urethra can be stretched or damaged, and may no longer provide enough support for the bladder or the urethra. Aging, menopause, and lack of estrogen can also lead to weakness in these muscles. Obesity can be another risk factor that leads to too much pressure on the bladder.
To diagnose stress urinary incontinence, the physician may first ask the patient to keep a diary of urinary symptoms. Urodynamic studies, which involve measuring urine flow and leakage, may also need to be done. If the symptoms of stress incontinence are severe enough, the physician may decide to perform the Burch procedure.
The Burch procedure is done to raise the bladder neck and stabilize the urethra to reduce the pressure from the bladder. Reducing this pressure should stop any unwanted leakage of urine. The procedure can be done as an open surgery or as a laparoscopic procedure.
A laparoscopic Burch procedure is done while the patient is under general anesthesia. The surgeon will make three to four small incisions in the abdomen and insert surgical instruments along with a camera to view the area. Permanent stitches will be placed on both sides of the bladder neck and attached to ligaments on the pubic bone. This should return the bladder to the correct position and relieve any pressure.
The laparoscopic procedure takes about an hour to perform. It only requires a one to two day stay in the hospital. Recovery and pain should be minimal, since the incisions are very small.
The Burch procedure can also be done as an open surgery. This requires a 3 to 5 inch (7.62 to 12.7 cm) incision in the abdomen and a longer hospital stay. There is also more pain associated with this surgery because of the longer incision.
Recovery at home following the Burch procedure involves limiting activity for the first two weeks. A patient should avoid any strenuous activity, heavy lifting, or sports for six weeks. Any signs of infection or difficulty in urinating should be reported to a physician.