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Paper Information

Title: 

"COMBINED SUPRAMEATAL VAGINO–ABDOMINAL URETHROLYSIS IN THE TREATMENT OF IATROGENIC URINARY OBSTRUCTION DUE TO PERVIOUS ANTI-INCONTINENCE SUSPENSION SURGERY"

Type: PAPER
Author(s): SHARIFI AGHDAS FARZANEH*,GHADERIAN NASSRIN
 
 *
 
Name of Seminar: CONGREH ANJOMAN UROLOGY IRAN
Type of Seminar:  CONGRESS
Sponsor:  ANJOMAN OROLOGY
Date:  2005Volume 8
 
 
Abstract: 

PROPOSE: TO INTRODUCE A SURGICAL TECHNIQUE IN THE TREATMENT OF PERSISTENT URINARY OBSTRUCTION DUE TO PREVIOUS ANTI–INCONTINENCE SUSPENSION SURGERY, UNRESPONSIVE TO CONSERVATIVE THERAPY.
METHODS & MATERIALS: DURING TWO YEARS (2001-2002) 12 PATIENTS WITH SYMPTOMATIC URINARY OBSTRUCTION DUE TO ANTI- INCONTINENCE SURGERY WERE REFERRED TO SHAHID LABBAFI NEJAD HOSPITAL. MEAN AGE WAS 49 (RANGE 43-57) YEARS. DURATION OF SYMPTOMS RANGED FROM 1 TO 10 (MEAN 2.9) YEARS. PREVIOUS SURGICAL TECHNIQUE WAS BURCH COLPO-SUSPENSION IN 6, MARSHALL–MARCHETTI-KRANTZ IN 3 AND PUBOVAGINAL RECTUS FASCIAL SLING IN 3 PATIENTS. PRE-OP EVALUATION CONSISTED: ULTRASOUND, URINE ANALYSIS AND CULTURE, NEUROLOGIC EXAM, CYTOURETHROSCOPY AND URODYNAMIC STUDY.
RESULTS: SURGICAL INTERVENTION WAS CARRIED OUT UNDER GENERAL ANESTHESIA AND LITHOTOMY POSITION. URETHROLYSIS WAS DONE VIA COMBINED VAGINO-ABDOMINAL APPROACH. MEAN OPERATIVE TIME WAS 160 (RANGE 125-200) MINUTES. THERE WAS NO INTRA-OPERATIVE COMPLICATION. SUPRAPUBIC AND URETHRAL CATHETER WAS INSERTED AND REMOVED 7 TO 10 DAYS THEREAFTER. MEAN FOLLOW-UP TIME IS 13 (3-24 RANGE) MONTHS. OBSTRUCTIVE URINARY SYMPTOMS WAS CURED IN 11 AND PARTIALLY IMPROVED IN ONE PATIENT. ONE PATIENT SUFFERS FROM MILD STRESS AND ANOTHER URGE URINARY INCONTINENCE.
DISCUSSION & CONCLUSION: THIS IS THE FIRST REPORT OF SUPRAMEATAL VAGINO-ABDOMINAL URETHROLYSIS IN IRANIAN FEMALE PATIENTS. IT IS SAFE AND EFFECTIVE IN THE TREATEMENT OF IATROGENIC OBSTRUCTIVE URINARY SYMPTOMS DUE TO PREVIOUS ANTI-INCONTINENCE SUSPENSION SURGERY UNRESPONSIVE TO CONSERVATIVE MANAGEMENT. THE RISK OF RECURRENCE OF STRESS URINARY INCONTINENCE IS LOW.

 
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