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Variations in strategy for the treatment of urethral obstruction after a pubovaginal sling procedure.
J Urol. 2000 Aug; 164(2):434-7.JU

Abstract

PURPOSE

We evaluated the success of several techniques for treating urethral obstruction and erosion after a pubovaginal sling procedure.

MATERIALS AND METHODS

Between April 1998 and June 1999, 32 women 33 to 79 years old (average age 62) who underwent a pubovaginal sling procedure with various materials were referred for the assessment of urethral obstruction. Patients were evaluated with a urogynecologic history, physical examination, voiding diary, cystoscopy and video urodynamics. Surgical procedures to resolve urethral obstruction were performed transvaginally and the specific techniques used were based on the type of sling material, urethral erosion and concomitant stress incontinence or other urethral pathology. Outcome measures were assessed by disease specific quality of life questionnaires, voiding diary and urogynecologic questionnaire.

RESULTS

Preoperatively 30 of the 32 women (93.7%) noticed urge incontinence, 20 (62.5%) performed intermittent self-catheterization, 6 (18.7%) had an indwelling catheter and 3 (9%) complained of concomitant stress urinary incontinence. After the sling takedown 29 patients (93.5%) achieved efficient voiding within week 1 postoperatively. Urge incontinence symptoms resolved in 20 cases (67%) but stress incontinence developed in 3 (9%). Of the 32 women 27 (84%) indicated that continence was much better than before the initial sling procedure.

CONCLUSIONS

Managing urethral obstruction after a pubovaginal sling procedure is challenging. Using various techniques based on sling material, urethral erosion and bladder neck integrity a successful outcome is possible in the majority of cases.

Authors+Show Affiliations

Divisions of Gynecologic Specialties and Urology, Duke University Medical Center, Durham, North Carolina, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10893603

Citation

Amundsen, C L., et al. "Variations in Strategy for the Treatment of Urethral Obstruction After a Pubovaginal Sling Procedure." The Journal of Urology, vol. 164, no. 2, 2000, pp. 434-7.
Amundsen CL, Guralnick ML, Webster GD. Variations in strategy for the treatment of urethral obstruction after a pubovaginal sling procedure. J Urol. 2000;164(2):434-7.
Amundsen, C. L., Guralnick, M. L., & Webster, G. D. (2000). Variations in strategy for the treatment of urethral obstruction after a pubovaginal sling procedure. The Journal of Urology, 164(2), 434-7.
Amundsen CL, Guralnick ML, Webster GD. Variations in Strategy for the Treatment of Urethral Obstruction After a Pubovaginal Sling Procedure. J Urol. 2000;164(2):434-7. PubMed PMID: 10893603.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Variations in strategy for the treatment of urethral obstruction after a pubovaginal sling procedure. AU - Amundsen,C L, AU - Guralnick,M L, AU - Webster,G D, PY - 2000/7/14/pubmed PY - 2000/9/19/medline PY - 2000/7/14/entrez SP - 434 EP - 7 JF - The Journal of urology JO - J Urol VL - 164 IS - 2 N2 - PURPOSE: We evaluated the success of several techniques for treating urethral obstruction and erosion after a pubovaginal sling procedure. MATERIALS AND METHODS: Between April 1998 and June 1999, 32 women 33 to 79 years old (average age 62) who underwent a pubovaginal sling procedure with various materials were referred for the assessment of urethral obstruction. Patients were evaluated with a urogynecologic history, physical examination, voiding diary, cystoscopy and video urodynamics. Surgical procedures to resolve urethral obstruction were performed transvaginally and the specific techniques used were based on the type of sling material, urethral erosion and concomitant stress incontinence or other urethral pathology. Outcome measures were assessed by disease specific quality of life questionnaires, voiding diary and urogynecologic questionnaire. RESULTS: Preoperatively 30 of the 32 women (93.7%) noticed urge incontinence, 20 (62.5%) performed intermittent self-catheterization, 6 (18.7%) had an indwelling catheter and 3 (9%) complained of concomitant stress urinary incontinence. After the sling takedown 29 patients (93.5%) achieved efficient voiding within week 1 postoperatively. Urge incontinence symptoms resolved in 20 cases (67%) but stress incontinence developed in 3 (9%). Of the 32 women 27 (84%) indicated that continence was much better than before the initial sling procedure. CONCLUSIONS: Managing urethral obstruction after a pubovaginal sling procedure is challenging. Using various techniques based on sling material, urethral erosion and bladder neck integrity a successful outcome is possible in the majority of cases. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/10893603/Variations_in_strategy_for_the_treatment_of_urethral_obstruction_after_a_pubovaginal_sling_procedure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5347(05)67378-8 DB - PRIME DP - Unbound Medicine ER -