Original Article

Retropubic urethrolysis and tape sectioning for obstruction following incontinence surgery. Long-term results

  • JESÚS ROMERO MAROTO
  • MANUEL ORTIZ GORRAIZ
  • JUAN J. MIRALLES BUENO
  • LUIS GÓMEZ PÉREZ
  • JUAN J. PACHECO BRU
  • CRISTÓBAL LÓPEZ LÓPEZ

Pelviperineology 2009;28(2):45-48

To evaluate the long terms results of retropubic urethrolysis and TVT tape section. Twenty-three patients were treated for clinicalurodynamic urinary obstruction following incontinence surgery between 1996 and 2004. Nineteen patients could be located and they completed a clinical review. Nine patients (Group I) underwent a retropubic urethrolysis procedure. In ten patients (Group II) section of the TVT sling was performed. Mean follow up was 59 ± 25 months in the urethrolysis group I (n = 9) and 39 ± 18 months in the TVT tape section group II (n = 10). All patients were reviewed by clinical interview, urine flowmetry, residual volume and cough test. Subjective assessment was carried out by questionnaires: SUIQ, I-QOL and PGI-I. Maximum average flow was significantly enhanced in both groups – to a greater extent in the TVT-section group. Residual volume disappeared in all cases. According to medical history, urgency was completely abolished in 12% of cases with relief in 87% in group I. In group II, urgency was totally eliminated in 66% with improvements seen in 33%. No patients, according to SUIQ questionnaire, were cured of their urgency incontinence in group I and only 50% in group II. I-QOL questionnaire showed 33% of patients in group I with more than 80 points and 50% in group II. The PGI-I questionnaire showed that 22% of patients in group I and 40% in group II experienced great improvement, and 33% in group I and 30% in group II showed sufficient improvement. Urethrolysis and tape sectioning can be highly successful to relieve iatrogenic obstruction and seem to be long-lasting. Complete resolution of storage symptoms is less likely. Quality of life evaluation of the outcome of urethrolysis and tape section is necessary.

Keywords: Iatrogenic obstruction; Stress urinary incontinence; Tape sectioning; Urethrolysis.