Management of Voiding Dysfunction Following Gynecological Surgery

Tsia-Shu Lo

《Incontinence & Pelvic Floor Dysfunction》 1卷4期 (2007/12) Pp. 141-144

https://doi.org/10.6259/IPFD.2007.1.4.141

並列摘要

Some operations for gynecological problems, especially prolapse and stress incontinence surgeries, are obstructive and may result in voiding dysfunction. Extreme elevation of the bladder neck, which occurs with over-enthusiastic colposuspension or undue tension being applied to a sling, is the most likely cause of postoperative voiding difficulty. Apart from obstructive causes, other causes are pharmacological, inflammatory, endocrine, over-distension and psychogenic. The true incidence of voiding dysfunction due to obstruction after gynecological surgery is difficult to ascertain. Impaired voiding may be asymptomatic but the majority is symptomatic. The simplest investigations include uroflowmetry and ultrasonography for residual urine. Urinary tract infection should be excluded as it may lead to voiding difficulty. Prevention or early recognition of retention may avoid long-term voiding difficulty. Clean intermittent self-catheterization is the principal treatment for chronic urinary retention. Diazepam used as an anxiolytic may help with postoperative voiding problems. Novel tension-free suburethral sling procedures rarely lead to voiding dysfunction. However, undue tension being applied to the sling is found to be the main cause of postoperative voiding dysfunction, thus necessitating the need to perform a sling take-down procedure.

並列關鍵字

gynecological surgery ； voiding dysfunction ； treatment