Retropubic urethropexy or Burch procedure is a procedure performed to suspend the bladder in females with urinary incontinence. Loss (incontinence) of urine is one of the most unpleasant complications of childbirth. The woman may leak urine from early morning to late at night- whenever she is on her feet and particularly with the stress of coughing or sneezing (therefore, sometimes called stress incontinence). She is dependent on wearing pads or diapers and there may be a constant odor of urine. Correction of this condition produces a very grateful patient.

Anatomy and Physiology

• The urinary bladder lies behind the pubic bone and in front of the vagina (Figure1)

Figure 1 - Anatomy of the pelvis as seen in a section cut through the center of the body from front to back (sagittal section). Note that the bladder is directly behind the pubic bone and in front of the vagina and uterus. The potential 'space' between the bone and bladder is called the 'space of Retzius'. During surgery these structures separate from each other like the pages in a book thus laying open the space of Retzius. © N. Gordon