Pressure-Flow Study and Urethrolysis in Treating Female Bladder Outlet Obstruction

TL;DR

This study examines how well pressure-flow studies predict successful outcomes after a procedure called transvaginal urethrolysis for treating female bladder outlet obstruction.

Contribution

The study is the first to evaluate the predictive value of pressure-flow parameters for transvaginal urethrolysis success in female bladder outlet obstruction.

Findings

Pressure-flow study parameters did not significantly predict success after transvaginal urethrolysis.

Success rates were 64.3% for clinically suspected fBOO and 50.0% for recurrent cystitis.

Postoperative urinary incontinence occurred in 52.6% of cases but did not require surgical correction.

Abstract

Introduction

Female bladder outlet obstruction (fBOO) is a challenging condition to diagnose. Pressure-flow studies are a key diagnostic tool, but the cutoff remains undefined. This study aims to evaluate the association between pressure-flow parameters and successful outcomes after transvaginal urethrolysis in patients with fluoroscopically confirmed bladder outlet obstruction.

Material and methods

This single-center retrospective cohort study included 30 women who were clinically suspected of having bladder outlet obstruction, with fluoroscopically confirmed bladder outlet abnormalities, and underwent transvaginal urethrolysis. All patients were assessed with a follow-up period of at least six months postoperatively. Success was defined as an improvement in lower urinary tract symptoms and/or the absence of clinical symptoms of cystitis, as reported by patients, along with no pyuria on urinalysis during the follow-up period.

Results

Among the 30 patients included in the study, 14 underwent urethrolysis primarily for clinically suspected bladder outlet obstruction, with a success rate of 64.3% (nine cases). Additionally, 16 patients were assessed for the resolution of recurrent cystitis, achieving a success rate of 50.0% (eight cases). None of the pressure-flow study parameters showed statistically significant differences between the success and failure groups. Postoperative de novo urinary incontinence was reported in 10 cases (52.6%) but none required surgical correction.

Conclusion

No pressure-flow study parameters accurately predict the success rate of transvaginal urethrolysis in treating patients with clinically suspected fBOO and fluoroscopic bladder outlet abnormalities. The success rates of transvaginal urethrolysis were 64.3% for clinically suspected fBOO and 50.0% for recurrent cystitis.

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