Anatomical Causes of Female Obstructive Voiding: Urethral Stricture and Anti-Incontinence Procedures

Obstructive voiding affects up to 29% of the female population. The iatrogenic causes of female urinary obstruction are preventable to an extent and deserve special consideration. These include urethral stricture and obstruction following surgery for stress urinary incontinence. An understanding of the etiology and diagnosis of these two forms of obstruction is necessary for successful identification and management of these conditions. The most commonly used approaches to diagnosis include urethroscopy, voiding cystourethrography and flurourodynamics. Treatment methods proven successful for urethral stricture include dilatation, urethroplasty, flaps, and grafting. Common treatment approaches for obstruction following surgical correction of SUI include catheterization, urethrolysis, and sling incision. This review will further examine the etiology, diagnosis, and treatment of urethral stricture and obstruction after surgery with the intent of contributing to a consensus on diagnostic approach and management of these conditions.