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Female obstruction after incontinence surgery may present different urodynamic patterns.
MedLine Citation:
PMID:  22752015     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION AND HYPOTHESIS: The aim of this study is to report a novel understanding of the urodynamic parameters used to diagnose iatrogenic female obstruction. There is no consensual definition of infravesical obstruction in women. Numerous criteria were designed with arbitrary cutoff values with poor clinical correlation. In order to determine the urodynamic profile of infravesical female obstruction we restricted our analysis to women who acquired voiding disturbances after being submitted to stress urinary incontinence (SUI) surgery. METHODS: A total of 302 women developed obstructive symptoms or voiding difficulties after SUI operations: 176 cases had had Kelly-Kennedy operations (58.2 %), 50 had had Burch operations (16.5 %), 37 (12.2 %) had had anterior colporrhaphy + abdominal (Burch) operations, 33 (10.9 %) had had sling operations, and 8 (2.6 %) had had Marshall-Marchetti operations. Obstructive urinary symptoms started in 1-120 days after the operation and urodynamic evaluations were done after various periods of time (median 18.4 months). Clinical presentations varied widely with irritative symptoms predominating the picture. RESULTS: Five patterns of pressure-flow relationships could be identified: (1) elevated pressure and poor flow (7.2 %), (2) normal pressure and poor flow (41.5 %), (3) normal pressure and flow associated with prolonged flow time (24.2 %), (4) poor detrusor contraction and elevated residual volume (12.9 %), and (5) elevated pressure and high flow (14.5 %). No relationship was established amongst the group and the Urinary Distress Inventory questionnaire. CONCLUSIONS: Infravesical obstruction in women does not fit a single model. As suggested, obstruction in women must be based on broad clinical pictures and urinary complaints.
Authors:
Paulo Rodrigues; Flávio Hering; Eli Cielici Dias
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-3
Journal Detail:
Title:  International urogynecology journal     Volume:  -     ISSN:  1433-3023     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101567041     Medline TA:  Int Urogynecol J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Neurourology and Voiding Disturbances, Beneficência Portuguesa Hospital of São Paulo, São Paulo, Brazil, paulortrodrigues@uol.com.br.
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