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The management of voiding difficulty after incontinence surgery

Urogynaecology Unit, Derriford Hospital, Plymouth, PL6 8DH, UK. email: luigi.bombieri{at}phnt.swest.nhs.uk (corresponding author)

Robert M Freeman, MD FRCOG, Consultant Obstetrician and Gynaecologist

Urogynaecology Unit, Derriford Hospital, Plymouth, UK.

Voiding difficulty can arise after any gynaecological surgery. This article focuses on voiding difficulty after anti-incontinence surgery, where voiding difficulty is more likely to persist and have serious clinical effects. Accurate urodynamic prediction is not always possible. Prevention relies on the appropriate choice of procedure for each individual patient and on subtle adjustments of surgical technique (e.g. avoidance of excessive elevation). The management of prolonged voiding difficulty relies on clean intermittent self-catheterization. Corrective surgical procedures (e.g. urethrolysis, division or release of sling) may play a role in individual cases. Preoperative counselling is important.

Keywords Keywords / colposuspension / incontinence / tension-free vaginal tape (TVT) / voiding difficulty