Illustration showing bladder neck procedure

Bladder neck suspension surgery adds support to the bladder neck and urethra, reducing the risk of stress incontinence. The Burch procedure involves placing sutures in vaginal tissue near the neck of the bladder — where the bladder and urethra meet — and attaching them to ligaments near the pubic bone. In a variation of this procedure — known as the Marshall-Marchetti-Krantz (MMK) operation — sutures placed in vaginal tissue are secured directly to the pubic bone.