Urethral obstruction after anterior colporrhaphy: Correction by simple vaginoplasty

Objectives. Bladder outlet obstruction is a well-known complication of anti-stress incontinence procedures including retropubic suspensions, needle suspensions, and slings. Relief of obstruction after these procedures usually requires freeing the urethra from its superior attachments. Because the anterior colporrhaphy does not involve suspension above the urethra, obstruction can be relieved by a simple plastic procedure involving the anterior vaginal wall. Methods. We describe 2 cases in which a simple plastic procedure was used to correct urodynamically confirmed obstruction after anterior colporrhaphy. Results. One patient became completely asymptomatic. The other had subjective and urodynamic resolution of her obstructive symptoms, but persistent detrusor instability. Conclusions. A simple plastic procedure can be used to correct urethral obstruction after anterior colporrhaphy.