Bladder Outlet Obstruction after Anti Incontinence Surgery Urethrolysis

Gamal M. Ghoniem and Usama M. Khater

Surgical correction of female stress urinary incontinence (SUI) generally results in success rates between 80% to 95%, depending on the procedure used.1 Bladder outlet obstruction (BOO) after surgical correction of SUI is not infrequent. Reported rates of urethral obstruction range from 5% to 20% after Marshall-Marchetti-Krantz procedure,2,3 5% to 7% after needle suspension and retropubic urethropexy,4 and 4% to 10% after pubovaginal sling.5 Obstruction after these procedures may result from excessive suture tension, periurethral suture placement, or excessive sling tension. Placing a supportive rather than obstructive sling is the best strategy for prevention of BOO.

With more slings being performed because of their long-term efficacy in all types of SUI, complications including obstruction are more prevalent. Failure to empty the bladder is not the only symptom that indicates obstruction. Physicians should be aware of this condition, to ensure that early recognition and treatment can be offered to these frustrated patients.

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