Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
To compare the anatomical change of urethra at rest and during straining following the tension-free vaginal tape (TVT) and TVT-obturator tape (TVT-O) procedures by three-dimensional (3-D) ultrasonography.
We retrospectively reviewed 48 women with stress urinary incontinence undergoing either TVT (n = 24) or TVT-O (n = 24) procedures. They all underwent urinalyses, pelvic examination, pad test, 3-D perineal ultrasonography and personal interview about urinary symptoms before and 1 year after surgery.
After both TVT and TVT-O procedures, the area, long axis, and short axis of hypoechoic core of mid-urethra decreased significantly from resting to straining (P< 0.001). The distance between tape and urethra also showed similar decreases in both groups. When analyzing ultrasound measurements in women reporting success (n=40) and failure (n=8), the area, long axis, and short axis of hypoechoic core of mid-urethra diminished significantly from resting to straining in both groups (P< 0.01). However, the short axis of proximal and distal urethra during straining showed significant decreases only in the success group (P< 0.01).
Urethral compression effect plays an important role in the continence mechanism. The anatomical change in the urethral morphology following TVT and TVT-O procedures was found to be similar.
Written by:
Lin KL, Juan YS, Lo TS, Liu CM, Tsai EM, Long CY. Are you the author?
Reference: Ultrasound Obstet Gynecol. 2011 Jun 8:132. Epub ahead of print.
doi: 10.1002/uog.9071
PubMed Abstract
PMID: 21656867
UroToday.com Stress Urinary Incontinence Section
