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Transvaginal tape lysis for urinary obstruction after tension-free vaginal tape placement
Andrew J Croak1, Valerie Schulte, Salvador Peron
1Department of Obstetrics and Gynecology, Section of Urogynecology and Reconstructive Pelvic Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
Purpose:
We examine the outcome of tape lysis in subjects with obstructive urinary retention after initial tension-free vaginal tape placement.
Materials And Methods:
Charts from 109 consecutive subjects who underwent tension-free vaginal tape placement from 1998 to 2001 were retrospectively reviewed. Of the subjects 78 (72%) consented to participation and completion of a questionnaire. All subjects underwent a routine preoperative evaluation before surgery and followup was implemented through 2002. Tape lysis using a standard technique was performed in 5 patients with documented obstructive urinary retention. Subjective assessment by the validated Bristol Lower Urinary Tract Symptoms questionnaire and a postoperative survey characterized perceptions of incontinence, results of initial tension-free vaginal tape placement and outcome of subsequent tape lysis.
Results:
The objective incontinence cure rate was 89%. Of the 78 patients 17 (22%) and 21 (27%) experienced transience in either dysuria or incomplete bladder emptying, respectively. Transection for obstructive urinary retention was successfully accomplished in 5 subjects with 4 (80%) remaining continent.
Conclusions:
Tape lysis is simple and effective for relieving obstruction, and is not associated with a high rate of recurrent stress urinary incontinence.
