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Sling incision with associated vaginal wall interposition for obstructed voiding secondary to suburethral sling procedure

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Abstract

Obstructed voiding is a well recognized complication following a suburethral sling procedure. Current methods of transvaginal and transabdominal urethrolysis have had variable success rates in relieving the obstruction, and do not restabilize the urethra to prevent potential postoperative stress incontinence. We report on a procedure used in 4 cases which addresses both of these issues. All patients had persistent urinary retention beyond 8 weeks after a suburethral sling procedure. An oupatient procedure consisting of sling incision and associated tissue interposition (vaginal wall in three cases and fascia lata in one) was successful in relieving the obstruction. Continence status was maintained in 3 of the 4 patients. There were no major complications of this outpatient procedure.

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References

  1. Juma S, Little NA, Raz S. Vaginal wall sling: four years later.Urology 1992;39:424–428.

    Article  PubMed  CAS  Google Scholar 

  2. Zimmern PE, Hadley HR, Leach GE, Raz S. Female urethral obstruction after Marshall-Marchetti-Kratnz operation.J Urol 1987;138:517–520.

    PubMed  CAS  Google Scholar 

  3. Beck RP, McCormick F, Nordstrom L. The fascia lata sling procedure for treating recurrent genuine stress incontinence of the urine.Obstet Gynecol 1988;72:699–703.

    PubMed  CAS  Google Scholar 

  4. Morgan E, Farrow GA, Stewart FE. The Marlex sling operation for the treatment of recurrent stress incontinence: a 16-year review.Am J Obstet Gynecol 1995;151:224–226.

    Google Scholar 

  5. Maloney PJ, Fenster HN. Bladder-neck incision for relief of obstruction after anti-incontinence surgery.Int Urogynecol J 1993;4:68–69.

    Article  Google Scholar 

  6. McGuire EJ, Letson W, Wang S. Transvaginal urethrolysis after obstructive urethral suspension procedures.J Urol 1989;142:1036–1039.

    Google Scholar 

  7. Webster GD, Kreder KJ. Voiding dysfunction following cystourethropexy: its evaluation and management.J Urol 1990;144:670–673.

    PubMed  CAS  Google Scholar 

  8. Foster HE, McGuire EJ. Management of urethral obstruction and transvaginal urethrolysis.J Urol 1993;150:1448–1451.

    PubMed  CAS  Google Scholar 

  9. Blaivas JG, Jacobs BZ. Pubovaginal fascial sling for the treatment of complicated stress urinary incontinence.J Urol 1991;145:1214–1218.

    PubMed  CAS  Google Scholar 

  10. McGuire EJ, Bennett CJ, Konnak JA, Sonda LP, Savastano JA. Experience with pubovaginal slings for urinary incontinence at the University of Michigan.J Urol 1987;138:525–526.

    PubMed  CAS  Google Scholar 

  11. Ghoniem GM, Elgamasy A-N. Simplified surgical approach to bladder outlet obstruction following pubovaginal sling.J Urol 1995;154:181–183.

    Article  PubMed  CAS  Google Scholar 

  12. Horbach, NS, Blancho JS, Ostergard DR, Bent AE, Cornella JL. A suburethral sling procedure with polytetrafluoroethylene for the treatment of genuine stress incontinence in patients with low urethral closure pressure.Obstet Gynecol 1988;71:648–652.

    PubMed  CAS  Google Scholar 

  13. Ghoniem GM, Shaaban A. Sub-urethral slings for treatment of stress urinary incontinence.Int Urogynecol J 1994;5:228–239.

    Article  Google Scholar 

  14. Henriksson L, Ulmsten U. A urodynamic evaluation of the effect of abdominal urethrocystopexy and vaginal sling urethroplasty in women with stress incontinence.Am J Obstet Gynecol 1978;131:77–82.

    PubMed  CAS  Google Scholar 

  15. Sze EH, Miklos JR, Karram MM. Voiding after Burch colposuspension and effects of concomitant pelvic surgery: correlation with preoperative voiding mechanism.Obstet Gynecol 1996;88:564–567.

    Article  PubMed  CAS  Google Scholar 

  16. Turner-Warwick R. Impaired voiding efficiency and retention. In: Stanton SL, ed. Clinics in Obstetrics and Gynecology. Philadelphia: WB Saunders; 1978:193–207.

    Google Scholar 

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McLennan, M.T., Bent, A.E. Sling incision with associated vaginal wall interposition for obstructed voiding secondary to suburethral sling procedure. Int Urogynecol J 8, 168–172 (1997). https://doi.org/10.1007/BF02764852

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