Retropubic cystourethropexy: is it an obstructive procedure?
OBJECTIVE
We sought to establish whether colpocystourethropexy creates bladder outlet obstruction, as evaluated by pressure-flow studies.


METHODS
We retrospectively analyzed the records of 50 women. Preoperative evaluation included a detailed questionnaire, physical examination, urine culture, cystourethroscopy and multichannel urodynamic testing. Every patient underwent retropubic colpocystourethropexy according to the Tanagho modification of the original Burch technique. An average of 3 months after the operation clinical evaluation and identical multichannel urodynamic testing were repeated. Preoperative and postoperative urodynamic parameters were compared for each patient and statistical differences were established using Student's 2-tailed t test.


RESULTS
No statistically significant difference was demonstrated in static urethral pressure profile parameters and in parameters during the filling phase of the cystometrogram except for cystometric capacity, which decreased after surgery (p = 0.02). In contrast, all 5 pressure-flow parameters analyzed (minimum urethral opening pressure, detrusor pressure at maximum flow, maximum flow, theoretical cross-sectional area and theoretical diameter of the flow rate controlling zone) showed statistically significant differences induced by surgery. Pressure-flow data reported on Schäfer's diagram and on the Abrams-Griffiths nomogram failed to demonstrate urodynamically significant obstruction created by surgery.


CONCLUSIONS
Our data suggest that colpocystourethropexy does not create obstruction but, rather, restores pressure-flow conditions to a normal or nearly normal level.
Bélair
G
G
Department of Surgery, Hôpital Maisonneuve-Rosemont, Université de Montréal, Québec, Canada.
Tessier
J
J
Bertrand
P E
PE
Schick
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D014521:Urethra; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology*; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014563:Urodynamics; D014621:Vagina