Voiding dysfunction following cystourethropexy: its evaluation and management.

Area of Science:

• Urology
• Female Pelvic Medicine and Reconstructive Surgery

Background:

• Cystourethropexy is a common procedure for anatomical stress incontinence.
• Dysfunctional voiding symptoms can arise after cystourethropexy.
• Revision surgery may be necessary for persistent symptoms.

Purpose of the Study:

• To evaluate the efficacy of obturator shelf repair in treating dysfunctional voiding symptoms post-cystourethropexy.
• To assess the resolution of bladder instability and urinary retention after revision surgery.

Main Methods:

• Retrospective review of 15 women who underwent cystourethropexy for stress incontinence and developed voiding dysfunction.
• All patients underwent retropubic takedown and subsequent obturator shelf repair.
• Outcomes including resolution of bladder instability and need for clean intermittent catheterization were assessed.

Main Results:

• 14 out of 15 patients (93%) achieved a successful outcome.
• 13 women with bladder instability symptoms experienced complete resolution.
• Only 1 of 7 patients requiring clean intermittent catheterization pre-operatively continued to need it post-operatively.

Conclusions:

• Obturator shelf repair is a highly effective revision procedure for dysfunctional voiding symptoms following cystourethropexy.
• This surgical approach successfully addresses bladder instability and improves bladder emptying.
• Revision surgery with obturator shelf repair offers a favorable outcome for complex cases of post-cystourethropexy voiding dysfunction.