Can urethrolysis resolve outlet obstruction related symptoms after Burch colposuspension for stress urinary incontinence?

Giannis, Georg; Bousouni, Evgenia; Mueller, Michael; Imboden, Sara; Mohr, Stefan; Raio, Luigi; Kuhn, Annette (2015). Can urethrolysis resolve outlet obstruction related symptoms after Burch colposuspension for stress urinary incontinence? European journal of obstetrics, gynecology, and reproductive biology, 195, pp. 103-107. Elsevier 10.1016/j.ejogrb.2015.09.033

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OBJECTIVE Bladder outlet obstruction may occur after any incontinence surgery and may present as OAB, hesitancy and or the feeling of incomplete emptying. Aim of this study was to analyze the clinical and urodynamical outcome after urethrolysis in patients presenting with various clinical symptoms after Burch colposuspension for stress urinary incontinence. STUDY DESIGN Between January 2005 and December 2014, all patients who presented with symptoms and with bladder outlet obstruction were included. All patients had undergone Burch or Cowan colposuspension for stress urinary incontinence previously. Primary endpoint was the visual analogue scale (VAS) as measurement of patient perceived disease impact. Secondary endpoints were the various domains of the King's Health Questionnaire, urodynamic parameters as detrusor pressure at maximum flow, residual urine and sonographic bladder wall thickness before and six months after intervention. RESULTS Seventy-two female patients were included in this study whereof 42 suffered from urgency and urge incontinence, 20 from hesitancy and/or slow stream, seven from residual urine of more than 100ml and three from a combination of urgency and residual urine. VAS improved significantly (p<0.0001). Quality of life as determined by the King's Health Questionnaire improved for the domains general health, role limitations, emotions, physical limitations, personal limitations and incontinence impact significantly. Micturition pressure dropped significantly from 43cmH2O (95% CI 19-59cmH2O) to 18cmH2O (95% CI 16-23.5 H2O). Residual urine changed from 110ml (range 20-380ml) to 32ml (20-115ml). Bladder wall thickness decreased from 7mm (95% CI 6.235-7.152) to 5mm (95% CI 5.037-5.607; p<0.01). CONCLUSION Urethrolysis may resolve patients' symptoms and lower micturition pressure but irritative symptoms may persist.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Giannis, Georg; Mueller, Michael; Imboden, Sara; Mohr, Stefan; Raio, Luigi and Kuhn, Annette

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1872-7654

Publisher:

Elsevier

Language:

English

Submitter:

Monika Zehr

Date Deposited:

25 Feb 2016 12:55

Last Modified:

25 Feb 2016 12:55

Publisher DOI:

10.1016/j.ejogrb.2015.09.033

PubMed ID:

26512435

Uncontrolled Keywords:

Burch colposuspension; OAB; Quality of life; Residual urine; Urethrolysis

BORIS DOI:

10.7892/boris.77796

URI:

https://boris.unibe.ch/id/eprint/77796

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