Laparoscopic urethrolysis followed by trans-obturator tape sling insertion for long standing voiding dysfunction...

This case report describes laparoscopic urethrolysis followed by trans-obturator tape sling insertion for voiding dysfunction after colposuspension. A 50-year-old patient presented with predominant stress incontinence of urine 14 after Burch colposuspension. There was no anterior vaginal wall prolapse on examination and urodynamic assessment confirmed voiding dysfunction in the absence of urodynamic stress incontinence. Clean intermittent self-catheterisation was tried, but failed to improve the patient's symptoms. Laparoscopic urethrolysis was carried out, leading to the relief of voiding dysfunction, but was followed by recurrence of stress incontinence. A trans-obturator tape sling was subsequently inserted with significant improvement in stress incontinence and the patient was discharged.