Effect of Urethral Dilatation on Women With Voiding Dysfunction

Abstract

Despite a lack of evidence for its efficacy in the literature, urethral dilatation (UD) has been used by urologists and urogynecologists for many years to treat a variety of lower urinary tract symptoms in women. Recent surveys of clinical practice suggest that a significant proportion of clinicians continue to perform UD, with it being more commonly used by those trained more than 10 years ago. Recent outcome data on UD in women with overactive bladder and voiding dysfunction have shown poor long-term efficacy, with a 13% risk of de novo urodynamic stress incontinence. Resolution of symptoms is associated with a postprocedure increase in maximum flow rate and a decrease in detrusor pressure at maximum flow. Further studies are needed to delineate the role, if any, of UD in the management of women with overactive bladder and voiding dysfunction.

Overactive bladder symptoms and voiding dysfunction in neurologically normal women

“…Treatment options for women with BOO are limited; relief of the obstruction in women could be compared to the effect of prostate surgery in men, which relieves OAB in two‐thirds of cases 28. However, it is a subject of controversy whether obstruction per se is etiologically important to the development of OAB initially28 or if the relief of the OAB symptoms in men following surgery is due to relief of obstruction alone, or rather a deafferentation of the urethra consequent upon resection of prostatic urothelium. Repair of genital prolapse or urethrolysis following continence procedures may provide relief of symptoms secondary to outlet obstruction in women.…”