Transvaginal urethrolysis for urethral obstruction after anti-incontinence surgery.

Published

Journal Article

PURPOSE: Urethral obstruction following a stress incontinence procedure occurs in 5 to 20% of patients. We examine the success of transvaginal urethrolysis in resolving voiding dysfunction. MATERIALS AND METHODS: A retrospective chart review was performed on 39 patients who had undergone transvaginal urethrolysis for urethral obstruction following an anti-incontinence procedure. Preoperatively, a history was taken, and pelvic examination and either video urodynamics or cystoscopy were done. RESULTS: All 39 patients complained of urge incontinence, 13% had urinary retention, 51% had incomplete bladder emptying and 36% voided to completion but had irritative voiding symptoms. Previous surgery included retropubic urethropexy in 41% of the cases, pubovaginal sling in 38% and bladder neck suspension in 21%. Mean length of followup after urethrolysis was 16 months. Of the 39 patients 33 (85%) had resolution of urge incontinence but 5 still required occasional intermittent catheterization. The remaining 6 patients had continued urge incontinence. An augmentation procedure was performed in 4 patients with improvement of symptoms. CONCLUSIONS: Our data support transvaginal urethrolysis for the treatment of iatrogenic urethral obstruction. It is a rapid, effective and minimally invasive technique that should be considered if voiding dysfunction does not resolve spontaneously.

Full Text

Duke Authors

Cited Authors

  • Cross, CA; Cespedes, RD; English, SF; McGuire, EJ

Published Date

  • April 1998

Published In

Volume / Issue

  • 159 / 4

Start / End Page

  • 1199 - 1201

PubMed ID

  • 9507832

Pubmed Central ID

  • 9507832

International Standard Serial Number (ISSN)

  • 0022-5347

Language

  • eng

Conference Location

  • United States