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Suprameatal transvaginal urethrolysis.

S P Petrou1, J A Brown, J G Blaivas

  • 1Department of Urology, Mayo Clinic, Jacksonville, Florida, USA.

The Journal of Urology
|March 19, 1999
PubMed
Summary
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This study shows suprameatal transvaginal urethrolysis effectively treats urinary obstruction after anti-incontinence surgery. The procedure offers a favorable success rate for improving voiding symptoms and resolving urinary retention.

Area of Science:

  • Urology
  • Female Pelvic Medicine and Reconstructive Surgery

Background:

  • Urinary obstruction can occur after anti-incontinence surgery.
  • Previous anti-incontinence procedures include pubovaginal sling, Marshall-Marchetti-Krantz, and Burch colposuspension.

Purpose of the Study:

  • To describe and assess a transvaginal suprameatal urethrolysis technique.
  • This method avoids lateral perforation of the urethropelvic ligament.

Main Methods:

  • 32 women underwent suprameatal transvaginal urethrolysis between 1993 and 1997.
  • Patients had prior anti-incontinence surgery and presented with urinary retention or voiding symptoms.
  • Diagnosis involved physical examination, cystourethroscopy, and video urodynamics.

Main Results:

Related Experiment Videos

  • 65% of women in urinary retention voided successfully post-procedure.
  • 67% of women with urgency symptoms experienced resolution.
  • Only one case of postoperative stress urinary incontinence was reported.

Conclusions:

  • Suprameatal transvaginal urethrolysis is a successful treatment for urinary obstruction post-anti-incontinence surgery.
  • Success rates were comparable whether obstruction was urodynamically confirmed or clinically presumed.
  • Preoperative maximal urinary flow rate predicted operative success.