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Speciality Spotlight
Urethra
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The Efficacy of Urethrolysis without Re-suspension for Iatrogenic Urethral Obstruction.
HB Goldman, et al (Cleveland Clinic Found, Ohio) J Urol 161: 196-199, 1999.
Urethral obstruction occurs in 1% to 20% of patients after surgery for stress urinary incontinence. Treatment consists of urethrolysis with or without resuspension. The efficacy of urethrolysis without resuspension was retrospectively evaluated.
Conclusion : Transvaginal urethrolysis without resuspension is an effective treatemnt for iatrogenic urethral obstruction. In this study, it resulted in a 77% success rate, with 7% voiding well but having some incontinence.
Editors comment that the dilemma facing the pelvic surgeon is whether another suspension should be done when taking down the previous sutures. The current report addresses this question and indicates that such a “resuspension” is not necessary. Seventy-seven percent of patients voided well without incontinence.
