Rate of recurrent stress urinary incontinence after retropubic urethrolysis

We determined the rate of recurrent female stress urinary incontinence after retropubic urethrolysis without a concomitant anti-incontinence procedure.

We reviewed the charts of all women who underwent urethrolysis at our institution for urethral obstruction due to an anti-incontinence procedure. The study was limited to patients who underwent retropubic urethrolysis without a synchronous anti-incontinence operation or interposition flap inlay for obstruction associated with a suburethral sling. Variables reviewed included the history of urethrolysis, success of retropubic urethrolysis and incidence of urinary incontinence after the operation.

A total of 12 patients met our study criteria, of whom 1 had stress urinary incontinence before retropubic urethrolysis. Of the 12 patients 10 achieved a successful result after urethrolysis and 2 achieved improvement but not success secondary to urinary urge incontinence. Protective padding was needed postoperatively for urinary incontinence in 5 of the 12 cases, including 3 (25%) and 2 (17%) due to stress and urgency incontinence, respectively. New onset stress urinary incontinence developed postoperatively in 2 of the 11 patients (18%) who did not have stress urinary incontinence before retropubic urethrolysis. A history of failed urethrolysis did not significantly increase the urinary incontinence rate postoperatively.

Although retropubic urethrolysis has a high potential success rate for resolving urethral obstruction, it may cause a higher incidence of recurrent stress urinary incontinence than transvaginal approaches. There is no clear need for a synchronous anti-incontinence procedure at the time of retropubic urethrolysis.