RETROPUBIC CYSTOURETHROPEXY - IS IT AN OBSTRUCTIVE PROCEDURE

Purpose: We sought to establish whether colpocystourethropexy creates bladder outlet obstruction, as evaluated by pressure-flow studies. Mat erials and Methods: We retrospectively analyzed the records of 50 wome n. Preoperative evaluation included a detailed questionnaire, physical examination, urine culture, cystourethroscopy and multichannel urodyn amic testing. Every patient underwent retropubic colpocystourethropexy according to the Tanagho modification of the original Burch technique . An average of 3 months after the operation clinical evaluation and i dentical multichannel urodynamic testing were repeated. Preoperative a nd postoperative urodynamic parameters were compared for each patient and statistical differences were established using Student's 2-tailed t test. Results: No statistically significant difference was demonstra ted in static urethral pressure profile parameters and in parameters d uring the filling phase of the cystometrogram except for cystometric c apacity, which decreased after surgery (p = 0.02). In contrast, all 5 pressure-flow parameters analyzed (minimum urethral opening pressure, detrusor pressure at maximum flow, maximum flow, theoretical cross-sec tional area and theoretical diameter of the flow rate controlling zone ) showed statistically significant differences induced by surgery. Pre ssure-flow data reported on Schafer's diagram and on the Abrams-Griffi ths nomogram failed to demonstrate urodynamically significant obstruct ion created by surgery. Conclusions: Our data suggest that colpocystou rethropexy does not create obstruction but, rather, restores pressure- flow conditions to a normal or nearly normal level.