Pelvic Floor Repair

SYMPTOMS

A 70 year old woman presented with severe stress incontinence and requested surgical intervention.

DIAGNOSIS

She had severe Lichen Sclerosus, a skin condition affecting the vulva - this would place her at increased risk of erosion from a mesh material. Suburethral slings (TVT-O) are the most commonly performed procedure around the world for treatment of stress incontinence.

PROCEDURE

The use of a mesh is avoided. A Laparoscopic Burch Colposuspension is an alternative procedure that elevates the bladder neck. These pictures demonstrate the elevation of the bladder neck using three sutures bilaterally.

OUTCOME

Follow up confirmed that the stress incontinence had resolved.

3 sutures on either side of bladder neck. The bladder is drained post-operatively with a supra-pubic catheter for 24 hours.