Abstract
We compare our postoperative outcomes of a vaginal vs abdominal urethrolysis after an obstructed Burch colposuspension. We performed a retrospective review of all women who had undergone a Burch urethrolysis from 1997 through 2003. Data collected included pelvic examination, cystoscopic and urodynamic findings, surgical morbidity, and pre- and postoperative urogynecologic symptomatology. Sixteen women underwent Burch urethrolysis. Preoperative symptoms were obstructive in 6, overactive in 2, and both (obstructive/overactive) in 8. All had an acute retropubic angulation of the urethral axis as well as a retropexed urethra that prohibited sagittal rotation of a rigid cystoscope. Seventy-eight percent of the women with urodynamic information met urodynamic criteria for urethral obstruction. Average follow-up was 7 months, and of those undergoing a vaginal urethrolysis, three out of seven (43%) had resolution of their obstructive or overactive symptoms postoperatively. In contrast, seven out of nine women (78%) who underwent a retropubic urethrolysis had relief of their obstructive or overactive bladder symptoms. In our cohort study, an abdominal retropubic urethrolysis was more successful in relieving urethral obstruction than a vaginal urethrolysis.
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This work was supported in part by the Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust and in part by the Kidney and Urology Foundation of America, Inc.
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Anger, J.T., Amundsen, C.L. & Webster, G.D. Obstruction after Burch colposuspension: a return to retropubic urethrolysis. Int Urogynecol J 17, 455–459 (2006). https://doi.org/10.1007/s00192-005-0037-y
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DOI: https://doi.org/10.1007/s00192-005-0037-y