Obstruction after Burch colposuspension: a return to retropubic urethrolysis |
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Authors: | Jennifer T. Anger Cindy L. Amundsen George D. Webster |
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Affiliation: | (1) Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA;(2) Division of Urogynecology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA |
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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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Keywords: | Female urology Bladder outlet obstruction Urethrolysis Urodynamics Burch urethropexy |
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