Management of urinary retention and obstruction following surgery for stress urinary incontinence

Urethral obstruction is a potential consequence of all types of anti-incontinence surgery. Not all patients will present in frank urinary retention: the surgeon must have a high index of suspicion to make the correct diagnosis in these cases. Important considerations in the diagnosis of these patients include the timing and methodology of evaluation. Formal urethrolysis in a variety of approaches has demonstrated similar cure rates and recurrent stress incontinence rates. Sling incision may provide an easier and less morbid approach to relieving obstruction caused by a pubovaginal sling with equal efficacy. The procedures are described and recent outcomes discussed.