Artículos de revistas
Transvaginal Urethrolysis For Urethral Obstruction After Anti-incontince Surgery [uretrolisis Transvaginal Tras Cirugía Correctora De La Incontinencia Urinaria De Esfuerzo]
Registro en:
Actas Urologicas Espanolas. , v. 29, n. 2, p. 207 - 211, 2005.
2104806
2-s2.0-20144372281
Autor
Palma P.C.R.
Dambros M.
Riccetto C.L.Z.
Thiel M.
Rodrigues Netto Jr. N.
Institución
Resumen
Purpose: To analyse the success of transvaginal urethrolysis in resolving voiding dysfunction in patients following an anti-incontinence procedure. Materials and Methods: A retrospective chart review was performed on 20 patients who had undergone transvaginal urethrolysis for urethral obstruction following an anti-incontinence procedure. Preoperatively, a history was taken, pelvic examination and urodynamic were done. Mean patient age was 48 years, and the median time between the anti-incontinence procedure and the urethrolysis was nine months. Four patients had urinary retention and had irritative voiding symptoms. Previous surgery included pubovaginal sling in eleven patients, retropubic urethropexy in three and bladder neck suspension in six cases. Mean length of follow up after urethrolysis was 14 months. The urodynamic study demonstrated voiding flow rate of 9,9ml/s and detrusor pressures at maximum flow of 48cmH2O. Results: Of the 20 patients 14 (70%) had relief of symptoms after a single urethrolysis, while two patients underwent a second transvaginal urethrolysis, with placement of a Martius flap between the urethra and the symphysis. There was no correlation between preoperative parameters examined and the outcome from urethrolysis. Conclusion: Our data support transvaginal urethrolysis for the treatment of urethral obstruction after anti-incontinence surgery. It is effective and minimally invasive technique with good results that should be considered if voiding dysfunction does not resolve spontaneously. 29 2 207 211 Marshall, V.F., Marchetti, A.A., Krantz, K.E., The correction of stress incontinence by simple vesicourethral suspension (1949) Surg Gynec & Obst, 88, pp. 509-515 Stamey, T.A., Endoscopic suspension of the vesical neck for urinary incontinence in females. Report on 203 consecutive patients (1980) Ann Surg, 192, pp. 465-471 Nitti, V.W., Raz, S., Obstruction following anti-incontinence procedures: Diagnosis and treatment with transvaginal urethrolyis (1994) J Urol, 152, pp. 93-98 Weinberg, M.W., Ostergard, D.R., Long-term clinical and urodynamic evaluation of the polytetrafluorethylene suburethral sling for treatment of genuine stress incontinence (1995) Obst Gynec, 86, pp. 92-98 Juma, S., Sdrales, L., Etiology of urinary retention after bladder neck suspension (1993) J Urol, 149 (PART 2), pp. 401A. , abstract 752 Zimmern, P.E., Hadley, H.R., Leach, G.E., Raz, S., Female urethral obstruction after Marshall-Marchetti-Krantz operation (1987) J Urol, 138, pp. 517-520 Holschneider, C.H., Solh, S., Lebhertz, T.B., Montz, F.J., The modified Pereyra procedure in recurrent stress urinary incontinence: A 15 year review (1994) Obst Gynec, 83, pp. 573-578 Horbach, N.S., Suburethral sling procedures (1991) Urogynecology & Urodynamics Theory and Practice, 3rd Ed., pp. 413-421. , Edited by DR Ostergard and AE Bent. Baltimore: Williams & Wilkins Cross, C.A., Cespedes, D., English, S.F., McGuire, E., Transvaginal urethrolysis for urethral obstruction after anti-incontinence surgery (1988) J Urol, 159, pp. 1199-1201 Bass, J.S., Leach, G.E., Bladder outlet obstruction in women (1991) Probl Urol, 5, pp. 141-146 Farrar, D.J., Osborne, J.L., Stephenson, T.P., Whiteside, C.G., Weir, J., Berry, J., Milroy, E.J.G., Turner Warwick, R., A urodynamic view of bladder outflow obstruction in the female: Factors influencing the results of treatment (1976) Brit J Urol, 47, pp. 815-819 Webster, G., Kreder, K., Voiding dysfunction following cystourethropexy: Its evaluation and management (1990) J Urol, 144, pp. 670-673 Massey, J.A., Abrams, P.H., Obstructed voiding in the female (1988) Brit J Urol, 61, pp. 36-99 McGuire, E.J., Letson, W., Wang, S., Transvaginal urethrolysis after obstructive urethral suspension procedures (1989) J Urol, 142, pp. 1037-1038 Carr, L.K., Webster, G.D., Voiding dysfunction following incontinence surgery: Diagnosis and treatment with retropubic or vaginal urethrolysis (1997) J Urol, 157, pp. 821-823