Cardiac risk evaluation

The aim of Burch colposuspension is to reposition the muscles that connect the bladder to the urethra (bladder neck). This helps them resist increases in abdominal pressure. This approach was widely used before midurethral slings were available. Slings have largely replaced colposuspension because they are easier to place and require a smaller operation.

When should I consider colposuspension?

Burch colposuspension is a good treatment option if a midurethral sling cannot be used. It is also an option if previous surgery for SUI didn’t work.

How is Burch colposuspension performed?

For Burch colposuspension, you will receive drugs to make you unconscious and insensitive to pain (general anaesthesia).


  • The bladder is emptied. Your doctor will insert a catheter to make sure that your bladder is completely empty during surgery.
  • The surgical instruments are inserted. Burch colposuspension can be performed by open surgery or laparoscopic surgery:
    • For open surgery the surgeon makes an incision in your lower abdomen to access the pelvic area directly.
    • For laparoscopic surgery, the surgeon inserts small plastic tubes into your abdomen. Through these tubes the surgeon can insert the instruments needed to perform the surgery. One of the small tubes is used to insert a camera which allows the surgeon to see a high-quality image of the area on a video monitor.
    • Laparoscopic and open surgery are equally effective to cure SUI in women. In general, hospital stay is shorter with laparoscopic surgery.
  • The bladder neck is lifted. The side of the vagina is attached to the ligament behind the pubic bone with sutures so that the bladder neck lies in a hammock. This will lift and support your bladder neck.
Because of the relation between ED and heart disease the doctor generally does a cardiac risk evaluation as part of the diagnosis. Your doctor may refer you to a cardiologist for further evaluation and specific cardiac tests, such as a ‘stress test.’