Corticosteroids to Prevent Recurrent Obstruction after Vaginal Urethrolysis

Abstract

Background Urethral obstruction may occur after anti-incontinence surgery. We describe the use of steroids to prevent recurrent obstruction after vaginal urethrolysis. Case A 22-year-old woman with a history of a Burch procedure complicated by obstruction and a failed vaginal urethrolysis is now 6 months from a second urethrolysis for outlet obstruction and without complaints. Postoperatively, she received periurethral injections of 10 mg of dexamethasone and 1% lidocaine without epinephrine (2.5 mL of dexamethasone and 1 mL of lidocaine) every 2 weeks for a total of 8 visits. The injections were given around the bladder neck, directed toward the symphysis. Conclusion Steroids should be considered in the prevention of outlet obstruction after vaginal urethrolysis.