title: Transvaginal urethrolysis for urethral obstruction after anti-incontinence surgery.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Medicine, University of Texas Medical School at Houston, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Cross
authors.forename: R D
authors.initials: RD
authors.lastname: Cespedes
authors.forename: S F
authors.initials: SF
authors.lastname: English
authors.forename: E J
authors.initials: EJ
authors.lastname: McGuire
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods; D014524:Urethral Obstruction / Q000209:etiology / Q000601:surgery*; D014549:Urinary Incontinence / Q000601:surgery*; D014621:Vagina