While the patient is deep asleep and pain-free (general anesthesia), the surgeon elevates the bladder neck (pubococcygeal muscle) by stitching it and the urethra to the anterior (front) pubic bone.
After surgery, the patient will have a Foley catheter and a suprapubic catheter in place. The urine may initially appear bloody but this should gradually resolve. The suprapubic catheter may be removed several days after surgery so that the patient is able to completely empty the bladder. Often this suprapubic catheter will need to remain in place for as long as 3 months, depending on the person's ability to empty the bladder completely.
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