Transvaginal closure of urethra and correction of uterovaginal prolapse in neurologically impaired patient with chronic indwelling catheter.
We report the case of a 38-year-old neurologically impaired woman with continuous urinary incontinence as a result of a chronic indwelling catheter for neurogenic bladder. Long-term catheter resulted in dilatation of urethra and pressure necrosis of urethra, with subsequent incontinence despite the catheter. She also had a stage 3 uterovaginal prolapse. She underwent cystoscopy, closure of urethra and bladder neck by transvaginal route (Feneley procedure), insertion of a suprapubic catheter, sacrospinous fixation and posterior colporrhaphy with prolene mesh (Apogee). Vaginal hysterectomy was declined by the patient and her family. She remained dry at follow-up visit and is happy with the outcome.
Kubal
U
U
Urogynaecology, City Hospital, Dudley Road, Birmingham B18 7QH, UK.
Arunkalaivanan
A S
AS
Baptiste
M
M
D000328:Adult; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D006801:Humans; D014521:Urethra / Q000601:surgery*; D001750:Urinary Bladder, Neurogenic / Q000150:complications*; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*; D014596:Uterine Prolapse / Q000150:complications / Q000601:surgery*