Voiding Dysfunction after SUI Surgery-Voiding Dysfunction after SUI Surgery

Video Transcription

Video Summary

In the webinar titled "Voiding Dysfunction After SUI Surgery," Dr. Steven Krause and Dr. David Austin discuss postoperative voiding dysfunction following mid-urethral sling surgeries for stress urinary incontinence. They cover the definition, causes, and diagnostic tests for voiding dysfunction, including cystoscopy, ultrasound, and urodynamic studies. The criteria for bladder outlet obstruction are explained, along with treatment options such as watchful waiting, pharmacotherapy, and urethral dilation. The use of alpha blockers and baclofen is also mentioned. The speakers address when to intervene and begin treatment based on pre-surgery symptoms. The webinar provides a comprehensive overview of postoperative voiding dysfunction and explores various management options.<br /><br />The video content focuses on the decision-making process in treating patients with sling-related complications, particularly obstructive urinary symptoms. Treatment options discussed include watchful waiting, sling loosening, sling incision, and formal urethral lysis, with the choice depending on patient preferences, benefits, risks, and symptom severity. Evidence from studies supports the different treatment options, considering success rates and potential risks. In cases where sling release or urethralysis relieves obstruction but leads to recurrent stress incontinence, bulking injections are suggested as a first-line option. If bulking is not effective or desired, other stress incontinence surgeries, such as mid-urethral sling or fascial sling, can be considered based on individual patient needs and physical exam findings. The speaker emphasizes the importance of individualized patient discussions and shared decision-making in determining the best treatment approach.

Asset Subtitle

David Ossin, MD & Stephen R. Kraus MD, MBA, FACS

Keywords

Voiding Dysfunction

SUI Surgery

Mid-urethral Sling

Stress Urinary Incontinence

Bladder Outlet Obstruction

Watchful Waiting

Pharmacotherapy

Urethral Dilation

Alpha Blockers

Baclofen