Stress urinary incontinence (SUI) is defined as the involuntary leakage of urine during moments of increased intra-abdominal pressure — for example, when coughing, sneezing, laughing, or lifting heavy objects. It is a common problem in women and significantly affects quality of life.
In women, SUI commonly arises due to urethral hypermobility (insufficient support to the bladder neck/urethra) or intrinsic sphincter deficiency (weakness of the urethral sphincter).
When SUI is addressed from a gynecologic perspective, it’s crucial to consider pelvic support, vaginal anatomy, coexisting pelvic organ prolapse, and any prior surgeries.
Women with SUI may present with:
- Leakage of small to moderate amounts of urine at times of exertion — e.g. coughing, sneezing, laughing, jumping
- Frequent need to change pads or protectors
- Avoidance of physical activity or embarrassment in social settings
- Some may also have mixed urinary incontinence (urge + stress)
- Occasionally, post-void dribbling
- Symptoms worsen with heavier physical activity, pregnancy, obesity, or pelvic floor weakening
If a patient comes to a gynecologist complaining of urinary leakage with exertion, it’s prudent to include SUI in the differential and proceed with appropriate evaluation (history, voiding diaries, pad test, urodynamics if needed).
Management generally follows a stepwise pathway:
- Conservative / Non-surgical measures
- Lifestyle modifications: weight loss, reduce bladder irritants
- Bladder training
- Pelvic floor muscle training (PFMT / Kegel exercises)
- Vaginal pessaries or urethral inserts
- Urethral bulking agents (less commonly used in pure SUI)
- Minimally invasive / Surgical intervention
- Mid-urethral sling procedures (e.g., tension-free vaginal tape, transobturator slings)
- Open retropubic colposuspension (Burch procedure)
- Laparoscopic Burch colposuspension — keyhole version of the Burch
- Other options: autologous fascial sling, novel meshes (with caution)
- Postoperative care & follow-up
- Pelvic floor rehabilitation
- Monitoring for complications
- Long-term surveillance of continence
Burch colposuspension is a surgical technique in which sutures are placed on each side of the urethra/vaginal wall and anchored to Cooper’s (iliopectineal) ligament, thereby elevating the urethrovesical junction and restoring the anatomical support so that intraabdominal pressure is transmitted properly.
Laparoscopic Burch colposuspension adapts this same principle via minimally invasive (keyhole) surgery. The steps are largely analogous to open Burch, but using laparoscopic ports, small incisions, and instrumentation.
Because laparoscopy uses smaller incisions than open Burch, it tends to offer quicker recovery, less pain, shorter hospital stay, and less morbidity—provided it is done by an experienced surgeon.
Cure or significant improvement rates at 1 year are often between 70–90 % for both open and laparoscopic Burch.
Dr. Hrishikesh Pandit is a recognized 3D laparoscopic gynecologic surgeon based in Ahilyanagar (Pandit Hospital), with expertise in advanced laparoscopic and minimally invasive gynecologic procedures.
At Pandit Hospital, you are in safe hands!
To consult Dr. Hrishikesh Pandit, Click Below,
FAQ
A: Stress incontinence is leakage occurring with exertion, coughing, sneezing, or physical activity. Urge incontinence is leakage associated with a strong, sudden urge to void (overactive bladder). Some women have mixed incontinence (both components).
A: If you have bothersome stress leakage interfering with daily life despite conservative measures (pelvic floor exercises, lifestyle changes), or if symptoms are worsening. Early evaluation lets you preserve options.
A: In experienced hands, it can often be done in about 1 hour (though surgical time may vary).
A: Hospital stay is shorter than open surgery. Most patients resume light activity in days, full recovery in several weeks. Catheterization may be needed briefly.
A: Bladder or ureter injury (<1 %), urinary retention, urinary tract infections, de novo urgency, bleeding, wound issues, and possibility of recurrent incontinence.
A: No. It is suited for stress-predominant leakage with urethral hypermobility. It’s less ideal in isolated intrinsic sphincter deficiency (no mobility), or in patients with significant detrusor overactivity, or fixed urethra.
A: Many women remain continent for years. Some may have decline over time; long-term studies show some drop in cure rate.
A: It depends. In select cases, concomitant prolapse repair may be done, and Burch can be combined. But the surgical plan must be individualized.
A: Avoids placing foreign mesh in the urethral area, beneficial in mesh-averse patients; good option when abdominal surgery is already planned; and in centers with laparoscopic expertise.
A: Mid-urethral slings became the “standard” for many years. However, due to scrutiny over mesh complications, colposuspension (open or laparoscopic) retains a role and may regain more use in specialized centers.
Pandit Hospital – Best Maternity care center in Ahmednagar
LET’S SEE OUR INTRO VIDEO
At Pandit Hospital, we provide all the maternity services from antenatal to postnatal period under one roof
Let's Connect!!
0241-2441717 / 0241-2442344
info.pandithospital@gmail.com
About author:
Dr. Hrishikesh Pandit:
Dr. Hrishikesh Pandit is one of the best obstetrician and gynecologist in India. He is also a well-renowned Laparoscopic surgeon. He obtained his MS (Ob Gyn) degree from the prestigious Pravara Institute of Medical Sciences. He has also done fellowship and diploma courses in laparoscopic surgeries and cancer treatment from Tata Hospital and Keil University, Germany. His surgical cases, papers and videos has been chosen in many international forums of gynecology.
At Pandit Hospital, we are always working hard to provide its patients with the highest level of medical innovation and patient care. With the aim of delivering complete maternity & gynecological care under one roof with the help of all contemporary amenities and cutting-edge medical equipment. Dr. Hrishikesh Pandit has a vision to bring the best of facilities regarding laparoscopy surgeries in the city of Ahmednagar. He is the pioneer of 3D Laparoscopy technology is Ahmednagar.
Latest Articles
Dr. Hrishikesh Pandit is one of the best laparoscopy surgeons in India. His determination to bring 3D Laparoscopy technology to Ahmednagar has eventually helped so many patients. Read the latest articles by Dr. Hrishikesh Pandit on Gynecology, gastric issues, and health tips for mothers during pregnancy.
Learn about stress urinary incontinence (SUI), its causes, signs, and management — and how Dr. Hrishikesh Pandit at Ahilyanagar offers laparoscopic Burch colposuspension as a minimally invasive solution for women suffering from SUI.
Dr. Hrishikesh Pandit, a pioneer of 3D laparoscopy in India and a leading expert in complex endometriosis care, managing intricate cases such as uretrolysis, bowel adhesions in Grade IV endometriosis and more
At Pandit Hospital, Ahilyanagar, Dr. Hrishikesh Pandit, one of the best 3D laparoscopic surgeons in India, performs advanced Laparoscopic Radical Hysterectomy (LRH) with outstanding outcomes.