MANAGEMENT OF URETHRAL OBSTRUCTION WITH TRANSVAGINAL URETHROLYSIS

Transvaginal urethrolysis was performed in 48 patients with urethral o bstruction following 1 or more urethral suspension procedures. A needl e suspension procedure had been performed in 19 patients (40%), retrop ubic urethropexy in 17 (35%) and pubovaginal sling in 10 (21%). A good response as indicated by normal voiding with minimal or no irritative symptoms was achieved in 33 patients (65%). The most common presentin g complaints were irritative voiding symptoms (71%) and urinary retent ion (60%). Fluoroscopic urodynamic evaluation frequently demonstrated urethral hypersuspension, a cystocele and/or elevated voiding pressure s. No patient had stress urinary incontinence as a result of the proce dure. Urethral obstruction should be recognized as a potential complic ation following surgical correction of female stress urinary incontine nce. Trans-vaginal urethrolysis is a safe and effective method to mana ge this problem.