Retropubic urethrolysis of colposuspension: does it improve voiding and overactive bladder symptoms?

The study aimed to assess the efficacy of retropubic urethrolysis (RU) on obstructive and overactive bladder (OAB) symptoms and to assess the effect on voiding parameters in a small series of six women. Each patient had significant obstructive or OAB symptoms, and was obstructed on urodynamics. RU was performed if conservative measures, anticholinergics and urethral dilatation failed. The mean time since colposuspension was 10 years. All patients complained of poor flow, with 5/6 complaining of OAB symptoms. Postoperatively, all the women reported improved voiding. The maximum flow rate increased from a mean of 11.2 ml/s to 16.4 ml/s, with the Pdet at a maximum flow decreasing from a mean of 43.2 cm H(2)O to 34.7 cm H(2)O. The post-void residual was less than 100 ml in all six patients postoperatively. One reported improved OAB symptoms. There are variable success rates for RU reported in the literature. Careful patient selection and counselling is necessary.