[Urethrolysis after surgical cure of stress urinary incontinence using colpopexy: surgical technics].
OBJECTIVE
Infravesical obstruction can occur after surgical cure for urinary stress incontinence (USI). Apart from palliative treatments with limited effects, this iatrogenic complication can be corrected by complete urethrolysis. The various indications and techniques of this surgery are presented.


METHODS
Urethrolysis is designed to release the urethra and bladder neck and can be performed via a transvaginal or retropubic approach. Some authors then recommend resuspension of the bladder neck, while others use a Martius or omentum flap to reduce the risk of restenosis.


RESULTS
The success of urethrolysis is measured by the return of normal micturition with complete disappearance of the irritating and/or obstructive symptoms. The success rate for the transvaginal procedure varies from 65% to 92% according to different teams, while the success rate via an abdominal incision was 93% in one series.


CONCLUSIONS
Urethrolysis is a difficult surgical technique, whose long-term results have not yet been precisely determined. The transvaginal route is associated with a low morbidity and remains our personal preference to release the obstructed urethra after operation for USI.
Chassagne
S
S
Department of Urology-UT, Southwestern Medical Center, Dallas, Texas, USA.
Haab
F
F
Zimmern
P
P
D000005:Abdomen / Q000601:surgery; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D009852:Omentum / Q000637:transplantation; D010166:Palliative Care; D011183:Postoperative Complications / Q000601:surgery*; D012008:Recurrence; D012307:Risk Factors; D013524:Surgical Flaps / Q000379:methods; D016896:Treatment Outcome; D014524:Urethral Obstruction / Q000209:etiology / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014554:Urination; D014621:Vagina / Q000601:surgery