Abnormal bladder emptying can be defined as difficulty in bladder evacuation. It has two major causes, lax uterosacral ligaments, and cystocoele. It can present as chronic urinary infection due to a high residual urine. Conventionally it is treated with urethral dilatation, even though there is no obstruction and the treatment is not very effective.
If the cause is from cystocoele, urgency may be associated, and the problem can be cured/improved by repairing the anatomical defects, in particular, lax cardinal ligaments. A standard well-conducted vaginal repair often works well, but in our experience, the best treatment is site specific repair of damaged cardinal/ATFP ligaments using tensioned minislings.
If the cause is from laxity in the uterosacral ligaments, pelvic pain and nocturia are often associated (“Posterior Fornix Syndrome”), and all are potentially curable with a posterior polypropylene sling.