Explain: Genuine stress incontinence

Content: Colposuspension (Modified Burch)

Clinical Information:

The female patient had urinary leakage during physical exercise, coughing and sneezing for years.

Urodynamic study {{GSI, D.I., mixed incontinence}} was noted.

Micro-tip urodynamic study {{not done, GSI, D.I., mixed incontinence}} was noted.

Pad test : gm.

Pelvic examination: [[No, Vaginal wall]] protruding prolapsed was noted.

ICS staging {{I, II, III, IV}}.

Menopause {{ +, -}}.

Hormone replacement therapy: {{yes, no}}

Urogynecologic ultrasonography {{ +, -}}.

Previous pelvic surgical history: [[no, Burch, Laparoscopic Burch, EBNS, Raz, Stamy, TVT, anterior colporraphy, posterior colporraphy, VTH, colposacropexy, S-S ligament suspension, others]]

Operative Procedures:

Type of operation: Colposuspension (Modified Burch) + [[ATH, BSO, RSO, LSO, anterior colporraphy, posterior colporraphy, colposacropexy]].

A {{subumbilical longitudinal, Pfannenstial, low median}} incision was made. A three bladed self-retaining retractor was used, the bladder is carefully dissected from the symphysis and the space of Retzius is exposed by blunt finger dissection. With the space of Retzius exposed, the operator placed his left forefingers in the vagina and elevated the lateral vaginal fornix. From the above, the upward vaginal cone was easily identified visually and by palpation. Using a sponge stick mounted on vaginal cone. The obturator fascia was recognized. A stitch of No. 1 {{Prolene, Ethibon/0-vaginal }} was suture are inserted into the left side vaginal cone , and then to the nearest point on the ipilateral ileopectineal ligament . Two sutures were performed on the right side of the bladder neck . Once all sutures were in position and hemostasis is complete, the sutures are tied. The abdominal cavity was examined and cleaned.

Operative Findings:

{{Bilateral vaginal fascia, Right vaginal fascia, Left vaginal fascia}} was sutured

No of stitch, Right : {{1, 2, 3}} , Left: {{1, 2, 3}}

Cystoscopy performed: {{ yes, no}}

Suprapubic cystostomy: {{ yes, no}}

Cystocele grade {{ I, II, III }}

Rectocele {{ I, II, III }}

Enterocele{{ +, -}}

{{Uterine prolapse, Vaginal cuff eversion}}: {{ I, II, III }}

Complication: [[massive bleeding, ureter injury, bladder injury, urethra injury, _______________]].

Dr:________________. Date: _______________.