Urodynamic effects of retropublic urethropexy in genuine stress incontinence

Literature reports of preoperative and postoperative urodynamic evaluations of women with genuine stress incontinence note a lack of effect of the surgical procedure on urethral functional length the closure pressure. This report indicates a different experience. Postoperative urodynamics 4 to 12 months following retropubic urethropexy in this group of patients demonstrated consistent and significant increases in urethral functional length and closure pressure with different patient positions and bladder volumes, when compared to preoperative studies. Postoperative stress testing also became normal. This augmentation of normal urethral function is most likely due to avoidance of midline periurethral dissection, which allows the normal urethra and urethrovesical junction to augment their functional capabilities unencumbered by iatrogenic periurethral scarification.