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Transvaginal urethrolysis for urethral obstruction after anti-incontinence surgery.
J Urol. 1998 Apr; 159(4):1199-201.JU

Abstract

PURPOSE

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.

MATERIALS AND 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+Show Affiliations

Department of Obstetrics, Gynecology and Reproductive Medicine, University of Texas Medical School at Houston, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9507832

Citation

Cross, C A., et al. "Transvaginal Urethrolysis for Urethral Obstruction After Anti-incontinence Surgery." The Journal of Urology, vol. 159, no. 4, 1998, pp. 1199-201.
Cross CA, Cespedes RD, English SF, et al. Transvaginal urethrolysis for urethral obstruction after anti-incontinence surgery. J Urol. 1998;159(4):1199-201.
Cross, C. A., Cespedes, R. D., English, S. F., & McGuire, E. J. (1998). Transvaginal urethrolysis for urethral obstruction after anti-incontinence surgery. The Journal of Urology, 159(4), 1199-201.
Cross CA, et al. Transvaginal Urethrolysis for Urethral Obstruction After Anti-incontinence Surgery. J Urol. 1998;159(4):1199-201. PubMed PMID: 9507832.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transvaginal urethrolysis for urethral obstruction after anti-incontinence surgery. AU - Cross,C A, AU - Cespedes,R D, AU - English,S F, AU - McGuire,E J, PY - 1998/3/21/pubmed PY - 1998/3/21/medline PY - 1998/3/21/entrez SP - 1199 EP - 201 JF - The Journal of urology JO - J Urol VL - 159 IS - 4 N2 - PURPOSE: 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. MATERIALS AND 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. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/9507832/Transvaginal_urethrolysis_for_urethral_obstruction_after_anti_incontinence_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5347(01)63554-7 DB - PRIME DP - Unbound Medicine ER -