Abstract
The technique of correcting urinary stress incontinence by means of sutures attached in the perivaginal fascia and anchored to Cooper's ligament, as described by Burch (1) is probably better than the more common Marshall-Marchetti-Krantz procedure (2). In the latter technique the sutures are fixed to the periosteum of the symphysis pubis. Both methods aim to lift up the urethra, fix it to connective tissue and maintain it in elevated position. The Cooper's ligament technique advocated by Burch affords a technically simpler anchorage, as the periosteum often breaks down when the sutures are tied. Although the more lateral Burch approach reduces the risk of penetrating the urethral wall with the sutures, the risk of penetration into the bladder is increased. This paper deals with two patients referred to us because of complications caused by unsuitably placed sutures in a Burch operation.
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