Diagnosis and treatment of voiding dysfunction caused by urethral obstruction after anti-incontinence surgery.

Voiding dysfunction after surgical treatment of stress incontinence may occur as a result of urethral obstruction secondary to hyperelevation of the bladder neck. The diagnosis of urethral obstruction after anti-incontinence surgery is often based upon patient symptomatology and physical examination without confirmation by urodynamic, endoscopic or other diagnostic studies. Urethrolysis seems effective in treating urethral obstruction and voiding dysfunction after surgical treatment of stress urinary incontinence. The reported high success rates of less-invasive procedures have not been confirmed by larger studies. Randomized prospective clinical trials are required to determine the optimal surgical treatment for prolonged voiding dysfunction after anti-incontinence procedures.