Urogynecology and Pelvic Surgery

Minimally Invasive Burch Urethropexy Procedure

What is a Burch urethropexy?

A Burch urethropexy is a procedure used to correct stress urinary incontinence (SUI). SUI is when you involuntarily leak urine (pee) when sneezing, laughing, coughing or doing exercise. It is a very common condition that occurs in 1 in 3 women.

SUI occurs when the muscles and tissues that support the urethra (the tube that carries urine from your bladder to outside your body) are weakened. The Burch urethropexy uses permanent sutures (stitches) to support the neck of the bladder (where the bladder and urethra connect) and stabilize the urethra. A total of 2 stitches are placed on each side.

How is the procedure performed?

Traditionally, a Burch urethropexy is done by cutting into your abdomen; however, Atrium Health Navicent Women’s Care offers minimally invasive Burch urethropexy, which is performed either laparoscopically or with robotic assistance. Laparoscopic surgery inserts surgical instruments through small incisions (cuts).

What are the advantages of minimally invasive Burch urethropexy?

Minimally invasive Burch urethropexy provides similar results to abdominal approach, but offers some benefits to you, including:

  • Decreased blood loss during surgery
  • Decreased pain after surgery
  • Faster return to normal activities
  • Smaller incisions

Minimally invasive Burch urethropexy often requires additional training to perform, so it is important to ask if your surgeon has that training, usually a fellowship in female pelvic medicine and reconstructive surgery.

What can I expect from Burch urethropexy?

You may be asked to undergo some bladder testing called urodynamic testing. You’ll need to attend a preoperative visit to talk to your doctor about what to expect and undergo some basic lab work. If you need surgical clearance or prior authorization, you’ll be asked to get this before surgery.

Minimally invasive Burch urethropexy takes approximately 1 hour. It uses several small incisions in the abdomen that allow the surgeon to use laparoscopic instruments to complete the surgery. If the robotic approach is used, similar incisions are created to allow placement of instruments. You will stay overnight in the hospital.

What will recovery be like?

Most patients report minimal pain with minimally invasive Burch urethropexy. You can expect some activity restrictions for 6 weeks, but many patients can return to a normal routine shortly after surgery. Activity restrictions include:

  • No heavy lifting of more than 10 pounds
  • No baths or soaking (showers are OK)
  • No sexual intercourse
  • No driving while on narcotic pain medications

What are the risks of minimally invasive Burch urethropexy?

The risk of complications from minimally invasive Burch urethropexy is typically very low. As with any procedure, there is a risk of anesthesia problems, pain, bleeding, infection, blood clots or damage to nearby organs. Risks specific to minimally invasive Burch urethropexy include:

  • urinary tract infection
  • problems emptying the bladder completely
  • bladder injury

Will my insurance company cover the procedure?

Our office will help you get prior authorization if your insurance policy requires it. If you have further questions, contact your insurance carrier for details of your coverage.