Modificações da uretra proximal e da junção uretrovesical decorrentes da cirurgia do tipo Kelly-Kennedy

Ribeiro, Cláudio Barros Leal; Brandt, Frederico Teixeira; Albuquerque, Carla Daisy Costa; Arraes, Fabíola; Neto, João Sabino Pinho; Avila, Mirella

doi:10.1590/s0102-86502002000700006

Cited by 4 publications

(22 citation statements)

References 2 publications

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“…Similar results have been described for the Kelly-Kennedy and tension-free vaginal tape (TVT) procedures [9,15,16] .…”

Section: Discussionsupporting

confidence: 74%

“…The importance of the urethrovesical junction (UVJ) and proximal urethra (PU) mobility in the maintenance of female urinary continence has already been established [4,[6][7][8][9][10][11] . However, the urodynamic evaluation determines only indirectly the UVJ and PU mobility, differently from what can be clearly demonstrated in real time imaging by ultrasound [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] .…”

mentioning

confidence: 99%

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Transvulvar ultrasound of urethrovesical junction and proximal urethra as prognostic markers of burch procedure outcome

Brandt¹,

Lorenzato²,

Almeida³

2012

JBGC

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Objective: To compare sonographic pre-and post-op parameters related to the urethrovesical junction (UVJ) and proximal urethra (PU) in women with stress urinary incontinence (SUI) surgically cured or not with the Burch procedure, and to evaluate whether these can be used as prognostic markers. Methods:Thirty female patients were selected by convenience sampling and assigned into two groups: 15 patients considered as clinically cured (the case group) and 15 as not cured (the control group). The enrollees were submitted to pre-(30 days prior) and post-op (180 days after) transvulvar ultrasound assessments of the UVJ and PU.Results: On post-op assessments measured on strain, the vertical UVJ distance from the inferior pubic border and the PU length were significantly larger in cured patients (12.87 ± 5.80mm vs 5.13 ± 6.55mm in controls, P<0.01; and 13.07 ± 6.44mm vs 6.20 ± 6.14mm in controls, P<0.01) respectively. The vertical UVJ displacement or descent and PU displacement or variation were significantly shorter in cured patients (8.47 ± 3.98mm vs 5.13 ± 2.36mm in controls, P< 0.001; and 8.33 ± 4.54mm vs 5.20 ± 2.90mm in controls, P< 0.05) respectively. More importantly, on pre-op assessments, only the PU displacement or variation was significantly larger in cured patients (15.87 ± 4.55mm vs 12.47 ± 3.52 mm in controls, P<0.05). Conclusions:Transvulvar ultrasound of the UVJ and PU can be used as prognostic markers of surgical outcomes in women with SUI treated with the Burch procedure.

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“…Similar results have been described for the Kelly-Kennedy and tension-free vaginal tape (TVT) procedures [9,15,16] .…”

Section: Discussionsupporting

confidence: 74%

mentioning

confidence: 99%

Transvulvar ultrasound of urethrovesical junction and proximal urethra as prognostic markers of burch procedure outcome

Brandt¹,

Lorenzato²,

Almeida³

2012

JBGC

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“…The main basic concept is to make sure the physiologic mechanisms of micturition will not be disturbed by either over or under suspension of the bladder neck. [ 7 – 10 ]…”

Section: Introductionmentioning

confidence: 99%

Tension-free vaginal tape versus lata fascia sling: The importance of transvulvar ultrasound in the assessment of relevant anatomical parameters in treatment of women with stress urinary incontinence

Lorenzato

et al. 2009

Indian J Urol

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Objective:To describe the relevance of transvulvar ultrasound in the assessment of anatomical differences induced by the lata fascia sling (LFS) and tension-free vaginal tape (TVT) procedures.Materials and Methods:Forty women with stress urinary incontinence (SUI), aged 30 to 60 years, have been treated with either LFS (20 patients) or TVT (20 patients). The transvulvar ultrasound of the urethrovesical junction (UVJ) and proximal urethra (PU) has been used as the main investigational tool both pre- and post-operatively. The studied parameters were the vertical (VUVJD) and horizontal (HUVJD) UVJ distances, the pubourethral distance (PUD) and the PU length.Results:The VUVJD did not vary significantly after the LFS surgery (P=0.10). The PUD became shorter (P=0.001) and the HUVJD became shorter only at rest (P=0.03) after the correction by LFS. The TVT procedure has led to shortening of the VUVJ displacement (P=0.0005) and of the PU length (P=0.02).Conclusions:The transvulvar ultrasound was of utmost importance in the demonstration that both the LFS and TVT surgical procedures elongate the PU, even though the LFS technique does it more efficiently. The LFS technique focus more on shortening the PUD and the TVT procedure focus more on the correction of the vertical UVJ displacement.

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“…In order to answer a proposed question, the Burch surgery was utilized because this technique can be considered as a golden standard (18) in the management of stress urinary incontinence and has been performed as a standard in the UFPE Unit for Research in Urinary Incontinence for more than ten years. However, until the contrary is proved by the argument that the surgical treatment must achieve the UVJ and PU repositioning in compliance with the logics of the passive urinary continence, what is valid for Burch surgery must correspond to other surgical procedure (15) .…”

Section: Discussionmentioning

confidence: 99%

“…However, the urodynamic study can only indirectly demonstrate the vertical mobility of the urethrovesical junction (UVJ) and proximal urethra (PU). Differently, ultrasonography can demonstrate a real image, with positioning and mobility of the UVJ and PU (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) .…”

Section: Introductionmentioning

confidence: 99%

Ultrassonografia uretrovesical como método eficaz de avaliação dos parâmetros prognósticos de tratamento cirúrgico da incontinência urinária de esforço

et al. 2009

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OBJETIVO: Comparar parâmetros ultrassonográficos relacionados à junção uretrovesical e uretra proximal em pacientes curadas e não curadas, tratadas cirurgicamente pela técnica de Burch, com a finalidade de estabelecer se há correspondência com fatores prognósticos. MATERIAIS E MÉTODOS: Trinta pacientes foram selecionadas e divididas em dois grupos: 15 consideradas clinicamente curadas e 15 consideradas não curadas. As pacientes foram submetidas a ultrassonografia transvulvar no pré-operatório e aos 30 e 180 dias do pós-operatório. RESULTADOS: No pré-operatório, o deslocamento da uretra proximal foi maior nas pacientes curadas (15,87 ± 4,55 mm × 12,47 ± 3,52 mm - p < 0,05). No pós-operatório, no esforço, a distância vertical da junção uretrovesical e a uretra proximal foram maiores nas pacientes curadas (12,87 ± 5,80 mm × 5,13 ± 6,55 mm - p < 0,01; e 13,07 ± 6,44 mm × 6,20 ± 6,14 mm - p < 0,01), e o deslocamento vertical da junção uretrovesical e da uretra proximal foi maior nas pacientes não curadas (8,47 ± 3,98 mm × 5,13 ± 2,36 mm - p < 0,001; e 8,33 ± 4,54 mm × 5,20 ± 2,90 mm - p < 0,05). CONCLUSÃO: A ultrassonografia da junção uretrovesical e da uretra proximal pode ser considerada como um método eficaz de avaliação dos parâmetros prognósticos do tratamento cirúrgico de mulheres com incontinência urinária de esforço.

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Modificações da uretra proximal e da junção uretrovesical decorrentes da cirurgia do tipo Kelly-Kennedy

Cited by 4 publications

References 2 publications

Transvulvar ultrasound of urethrovesical junction and proximal urethra as prognostic markers of burch procedure outcome

Transvulvar ultrasound of urethrovesical junction and proximal urethra as prognostic markers of burch procedure outcome

Tension-free vaginal tape versus lata fascia sling: The importance of transvulvar ultrasound in the assessment of relevant anatomical parameters in treatment of women with stress urinary incontinence

Ultrassonografia uretrovesical como método eficaz de avaliação dos parâmetros prognósticos de tratamento cirúrgico da incontinência urinária de esforço

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