Abstract

Sling surgery has supplanted other anti-incontinence procedures as the treatment of choice for stress urinary incontinence. Iatrogenic obstruction after sling surgery is increasingly reported as the procedure becomes more and more popular. The rate of retention (defined as catheter-dependency for at least 28 days) has been estimated at 1-10%. Iatrogenic obstruction after sling surgery has a variable presentation and can include urinary urgency, urgency incontinence, hesitancy, straining to void, weak urinary stream, nocturia, incomplete emptying, frequency, dysuria or urinary tract infections. The evaluation and diagnosis rely upon a thorough patient history, physical examination, a urine flow test and postvoid residual volume. Cystoscopy and pressure-flow studies can also be considered. The single most important factor in the diagnosis of sling-related obstruction or voiding dysfunction is the temporal relationship between the sling procedure and onset of symptoms. Transient urinary retention can be managed with indwelling or intermittent catheter drainage. For those patients with moderate or symptomatic retention, surgical options for treatment include sling loosening, sling incision, sling excision, and urethrolysis.

Links

Publisher Full Text

Authors

Patel BN, Kobashi KC, Staskin D

Institution

Virginia Mason Medical Center, Section of Urology and Renal Transplantation, C7-URO, 1100 9th Avenue, Seattle, WA 98101, USA.

Source

Nature reviews. Urology : 2012 Jun 5 pg

Pub Type(s)

JOURNAL ARTICLE

Language

ENG

PubMed ID

22664930