Conservative management as an initial approach for post-operative voiding dysfunction

The management of voiding dysfunction after tension-free vaginal tape (TVT) remains controversial. Timing of surgical intervention is debatable and the role of conservative management is not well researched. This study aims to determine whether self catheterisation is an effective first line management option for these patients.

389 women underwent a TVT operation over a five year period. Twenty-two (5.6%) developed post-operative voiding dysfunction. Twenty women commenced CISC and their progress was monitored by recording voided volumes and residual urine volumes in a voiding diary and uroflowmetry. Residual volumes of less than 100 ml s were considered normal.

Voiding function returned to normal with self catheterisation in 72% of patients and of these, 85% were cured in less than 12 weeks.

CISC is a suitable and effective initial approach to managing the majority of cases of voiding dysfunction and avoids the risks associated with further surgery, including the recurrence of stress incontinence.