Surgery for the incompetent urethral sphincter: Bladder neck suspension procedures

For over 50 years, bladder neck suspension procedures have been performed by urologists and gynecologists for the treatment of urinary incontinence secondary to bladder neck and proximal urethral hypermobility (genuine stress incontinence; GSI). Although the first true retropubic suspension is credited to Marshall and co-workers (1), over the past 50 years, multiple techniques for achieving this same goal have been described. Pereyra (2), Burch (3), Stamey (4), and Raz (5) have been credited with major modifications in the technique of bladder neck suspension (BNS), among others, The purpose of the current chapter is to give an overview of the goal of these procedures, their respective advantages, their longterm results, their potential complications, and their current place in the treatment of stress urinary incontinence (SUI).