Management of urethral obstruction with transvaginal urethrolysis.
Transvaginal urethrolysis was performed in 48 patients with urethral obstruction following 1 or more urethral suspension procedures. A needle suspension procedure had been performed in 19 patients (40%), retropubic urethropexy in 17 (35%) and pubovaginal sling in 10 (21%). A good response as indicated by normal voiding with minimal or no irritative symptoms was achieved in 33 patients (65%). The most common presenting complaints were irritative voiding symptoms (71%) and urinary retention (60%). Fluoroscopic urodynamic evaluation frequently demonstrated urethral hypersuspension, a cystocele and/or elevated voiding pressures. No patient had stress urinary incontinence as a result of the procedure. Urethral obstruction should be recognized as a potential complication following surgical correction of female stress urinary incontinence. Transvaginal urethrolysis is a safe and effective method to manage this problem.
Foster
H E
HE
Department of Surgery, University of Michigan Hospitals, Ann Arbor.
McGuire
E J
EJ
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods; D014521:Urethra / Q000601:surgery*; D014524:Urethral Obstruction / Q000503:physiopathology / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000601:surgery; D014563:Urodynamics; D014621:Vagina