Proposed Cutoff Values to Define Bladder Outlet Obstruction in Women

Chassagne, S.; Bernier, P.A.; Haab, F.; Roehrborn, Claus G.; Reisch, Joan; Zimmern, P.

doi:10.1016/s0022-5347(01)61869-x

Cited by 49 publications

(77 citation statements)

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“…Some authors have attempted to improve diagnostic accuracy by constructing pressure-flow nomograms in women to diagnose bladder outlet obstruction. Chassagne [17] reported that the best prediction of obstruction occurred with a maximum flow rate of 15 ml/s or less and a detrusor pressure at maximum flow of more than 20 , and the X-ray appearance of the bladder outlet compared to unobstructed cases [18]. Using videourodynamics, cases were classified as obstructed if there was obstruction between the bladder neck and distal urethra in the presence of a sustained detrusor contraction.…”

Section: Resultsmentioning

confidence: 99%

Voiding dysfunction after surgery for stress incontinence: literature review and survey results

et al. 2003

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Postoperative voiding dysfunction is a potential complication of anti-incontinence procedures. Reported rates of urethral obstruction range from 5% to 20%. There is a lack of consensus in the literature regarding the appropriate evaluation and management of this distressing problem. A literature search was carried out using Medline (1966-2001) for postoperative voiding dysfunction. The key word urethrolysis was cross-referenced with surgical complications and stress urinary incontinence to identify all published English-language articles. The bibliographies of reviewed articles were searched manually. We also mailed a survey to the members of American Urogynecologic Society (AUGS) regarding their management of this problem. Overall, 262 members (31.4%) responded to the survey. Success rates reported in the literature between retropubic and vaginal techniques of urethrolysis are comparable, but morbidity is lower with the vaginal approach. The success rates are equivalent with (68%) or without (74%) resuspension following transvaginal urethrolysis. The incidence of postoperative SUI is acceptably low even without resuspension of the urethra (6% for both). Results of the AUGS survey reveal that most providers favor a transvaginal approach (74%) when performing urethrolysis, and they do not routinely resupport the bladder neck (82%).

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Section: Resultsmentioning

confidence: 99%

Voiding dysfunction after surgery for stress incontinence: literature review and survey results

et al. 2003

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“…Symptoms suggestive of postoperative voiding dysfunction are usually divided into obstructive and irritative symptoms, but these symptoms are neither highly sensitive nor specific for the presence or absence of obstruction [15]. Although various cutoffs for pressure and flow have been described, currently, a standard definition for bladder outlet obstruction in women does not exist [16,17]. Additionally, several studies have shown that preoperative urodynamics does not correlate well with postoperative urethrolysis results [18].…”

Section: Discussionmentioning

confidence: 99%

Various surgical approaches to treat voiding dysfunction following anti-incontinence surgery

et al. 2006

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“…Patients may present with either obstructive or irritative symptoms in these situations. Although we generally use a voiding detrusor pressure at maximum flow above 20 cm H 2 O and a maximum flow rate below 12 ml/s as cutoffs for defining BOO in our practice, we recognize that there is no consensus as to what numbers best define BOO in the female patient [20,21]. These urodynamic parameters must be placed in the context of the other findings.…”

Section: Discussionmentioning

confidence: 99%

Transvaginal urethrolysis for obstruction after antiincontinence surgery

McCrery

2006

Int Urogynecol J

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Our objective was to determine our success in relieving bladder outlet obstruction (BOO) with a transvaginal urethrolysis (TVU). This was a chart review that included 55 patients who underwent 61 TVU procedures between 2001 and 2005. Twenty-three patients had at least one prior TVU. Outcomes evaluated included obstructive symptoms, need for catheterization, postvoid residual (PVR), irritative symptoms, and stress urinary incontinence (SUI). Of the 46 patients with obstructive voiding preoperatively, 87% were cured. Of the 47 patients with irritative symptoms, 45% were cured, 34% improved, and 21% were left unchanged. SUI, generally mild, was noted postoperatively in 16% patients. Similar success was seen among patients with prior procedures. Aggressive TVU is very successful in relieving urinary retention and improving or curing overactive bladder symptomatology due to iatrogenic obstruction, even when a prior urethrolysis had been unsuccessful. SUI is an infrequent complication.

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Proposed Cutoff Values to Define Bladder Outlet Obstruction in Women

Cited by 49 publications

References 0 publications

Voiding dysfunction after surgery for stress incontinence: literature review and survey results

Voiding dysfunction after surgery for stress incontinence: literature review and survey results

Various surgical approaches to treat voiding dysfunction following anti-incontinence surgery

Transvaginal urethrolysis for obstruction after antiincontinence surgery

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