Determination of bladder neck position by intraoperative introital ultrasound in colposuspension: outcome at 6‐month follow‐up

Viereck, Volker; Bader, W.; Skala, Christine; Gauruder-Burmester, A.; Emons, Günter; Hilgers, Reinhard; Krauss, Thomas F.

doi:10.1002/uog.1099

Cited by 10 publications

(11 citation statements)

References 39 publications

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“…Introital ultrasound was performed with the vaginal probe (6 MHz) placed on the introitus just underneath the external urethral orifice without exerting pressure on the probe and in such a way that good views of the bladder, bladder neck, and urethra were obtained. The technique has been described in detail earlier [6,[14][15][16]19]. All ultrasound measurements were performed at rest and during the Valsalva maneuver with a bladder filling volume of about 200-300 ml.…”

Section: Methodsmentioning

confidence: 99%

“…All ultrasound scans were evaluated by the same reader. Intrarater variability was determined in earlier studies and was ±3 mm [15,16].…”

Section: Methodsmentioning

confidence: 99%

“…In Anglo-American countries, the Q-tip test continues to be widely used to diagnose inadequate anchorage of the urethra under increased intra-abdominal pressure [3][4][5]. Ultrasonography (introital, perineal, or endovaginal) is a noninvasive modality that is easy to perform and at the same time provides not only information on mobility but also morphologic data on the bladder neck and proximal urethra [6][7][8][9][10][11][12][13][14][15][16]. However, a generally accepted definition of abnormal bladder neck mobility, referred to as "urethral hypermobility," does not exist [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

“…The effects of bladder neck elevation on bladder neck mobility can be evaluated by ultrasound [6,[14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

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Urethral hypermobility after anti-incontinence surgery—a prognostic indicator?

et al. 2006

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The aim of this study was to define the concept of hypermobility of the bladder neck and determine its effects on the cure rate and postoperative complications in patients undergoing colposuspension. In a retrospective study, 310 patients who underwent primary colposuspension for urodynamically proven genuine stress urinary incontinence were assessed by introital ultrasound before surgery and during follow-up for up to 48 months postoperatively. A total of 152 women completed 48 months of follow-up. Mobility of the bladder neck during straining was described as linear dorsocaudal movement (LDM) with LDM >15 mm being defined as hypermobility. The overall objective cure rate was 90.0% at 6-month follow-up vs 76.8% at 48-month follow-up (Kaplan-Meier estimators). Urge symptoms occurred in 12.6% (39/310) of the women and de novo urge incontinence in 2.3% (7/310). Bladder neck hypermobility was significantly reduced after anti-incontinence surgery, from 67.1% (208/310) before surgery to 5.5% (17/310) immediately after surgery (P<0.0001). Postoperative hypermobility was associated with a higher recurrence rate. In the hypermobility group, 52.9 and 34.0% of the patients were continent for up to 6 and 48 months, respectively, as opposed to 92.2 and 79.2% in the group without hypermobility (P<0.0001). Women with postoperative hypermobility had a 3.2-fold higher risk of recurrence within 48 months. Bladder neck hypermobility after surgery was also associated with postoperative voiding difficulty (P=0.0278). Patients in whom hypermobility of the bladder neck diagnosed before surgery persists after colposuspension have a higher risk of recurrence and are more likely to develop postoperative complications than those without this hypermobility.

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Section: Methodsmentioning

confidence: 99%

“…All ultrasound scans were evaluated by the same reader. Intrarater variability was determined in earlier studies and was ±3 mm [15,16].…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The effects of bladder neck elevation on bladder neck mobility can be evaluated by ultrasound [6,[14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Urethral hypermobility after anti-incontinence surgery—a prognostic indicator?

et al. 2006

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“…All postoperative measurements showed a signi¢cant reduction of the median linear movement of the BN during straining. Incontinence surgery resulted in a significant reduction of funneling and hypermobility 6 months after surgery [Viereck et al, 2004b]. Introital ultrasonographic surveillance could be a suitable technique to visualize the result of surgery in terms of position or misplacement of the tape afterTVT procedure [Lo et al, 2001].…”

Section: Standardizationmentioning

confidence: 99%

Role of perineal ultrasound in the evaluation of urinary stress incontinence and pelvic organ prolapse: A systematic review

Dalpiaz

Curti

2006

Neurourology and Urodynamics

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Use of intraoperative ultrasound to improve tension‐free vaginal tape‐obturator placement: A pilot study

González-Díaz

Fernández-Llamas

Corral

et al. 2023

Intl J Gynecology & Obste

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Objective To evaluate the use of intraoperative ultrasound (IUS) to achieve a postoperative optimal placement of the tension‐free vaginal tape‐obturator (TVT‐O). Methods A cohort study was performed among women who underwent TVT‐O placement. In 25 women, ultrasound was used for the placement, and based on current evidence, the optimal intraoperative and postoperative ultrasound pattern was selected. They were compared with 25 women where IUS was not used. Results IUS increased operative time (by 7.5 min), and in 36% (9/25) of cases it was necessary to perform some corrections based on the ultrasound findings. After 1 month, in patients of the IUS group, the tapes were more frequently placed at a distance of 3–5 mm (P = 0.01), and it was more common for it to be placed between 40% and 70% relative to the urethral length (P = 0.011). Of tapes placed with IUS, 76% (met the optimal postoperative ultrasound pattern, as opposed to only 48% placed without IUS (P = 0.041). No differences were found in the complications or the functional results at 1 month post‐surgery. Conclusion The use of IUS for the placement of TVT‐O allows us to position them optimally and avoid erroneous placements, although IUS increases the operative time without improving the functional results and the rate of complications.

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Determination of bladder neck position by intraoperative introital ultrasound in colposuspension: outcome at 6‐month follow‐up

Cited by 10 publications

References 39 publications

Urethral hypermobility after anti-incontinence surgery—a prognostic indicator?

Urethral hypermobility after anti-incontinence surgery—a prognostic indicator?

Role of perineal ultrasound in the evaluation of urinary stress incontinence and pelvic organ prolapse: A systematic review

Use of intraoperative ultrasound to improve tension‐free vaginal tape‐obturator placement: A pilot study

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