Sonographic appearance of transobturator slings: implications for function and dysfunction

Chantarasorn, Varisara; Shek, Ka Lai; Dietz, Hans Peter

doi:10.1007/s00192-010-1306-y

Cited by 85 publications

(92 citation statements)

References 17 publications

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“…There are studies using PFS-TV showing that the relative tape position, the tape-urethra distance and the urethral mobility toge- ther have a definitive impact on the cure rate [15,22,23]. However, Dietz et al, using PFU-TA, was not able to confirm the results obtained during PFS-TV [32]. POP is a common female disease [33].…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of a pre-pubic four-arm NAZCA-TC mesh in treating cystocele and stress urinary incontinence simultaneously — results controlled with a pelvic floor ultrasound. A preliminary study

Wlaźlak¹,

Kluz²,

Wróbel³

et al. 2017

Ginekol Pol

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Objectives: It is controversial whether pelvic organ prolapse and stress urinary incontinence (SUI) should be treated simultaneously with a single surgery or separately with two procedures. The pre-pubic four-arm NAZCA-TC® mesh was invented to treat cystocele and SUI with a single procedure. The objective of this study is to analyze short-term results after the implantation of NAZCA-TC mesh. Material and methods:A total of 18 women underwent the evaluation of results of mesh implantation within a 24 to 36 months follow-up. Pre-operatively, patients were examined under standardized conditions. Postoperatively we analyzed the following: standardized interview and examination as well as pelvic floor ultrasound: 2D with a transvaginal probe and 4D with an abdominal probe.Results: There was one case of intraoperative bladder damage noticed and repaired followed with NAZCA implantation. In 2 cases vaginal erosion was found that healed successfully after re-operation. In 3 cases hematomas were observed but resolved spontaneously. After the surgery there was a statistically significant improvement of prolapse in anterior (p < 0.0003) and in central (p < 0.001) compartment. Six women (33.3%) had no stress urinary incontinence symptoms during the control visit but we did not find a statistically significant improvement in SUI symptoms after the procedure. We recorded no case of hypomobile urethra after the surgery. The mesh covered > 50% of the urethral length in all of the patients. Conclusions:Mid-term results showed that implantation of NAZCA TC mesh allows to achieve statistically significant improvement in reducing cystocele coexisting with enterocele in over 65% of patients. A complete cure from stress urinary incontinence was confirmed in 1/3 of patients. NAZCA-TC covered more than 50% of the urethral length, which can possibly have a negative influence on the effectiveness of the suburethral tape.

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Section: Discussionmentioning

confidence: 99%

The effectiveness of a pre-pubic four-arm NAZCA-TC mesh in treating cystocele and stress urinary incontinence simultaneously — results controlled with a pelvic floor ultrasound. A preliminary study

Wlaźlak¹,

Kluz²,

Wróbel³

et al. 2017

Ginekol Pol

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“…There are several studies analyzing the association between the position of the tape and the outcome in stress incontinent patients [2–9]. Most works measure the tape-symphysis pubis distance [2, 11, 12] on the midsagittal plane and, in addition, the tape position in relation to urethral length [2, 4–8, 11]. …”

Section: Discussionmentioning

confidence: 99%

“…Multiple studies [2–9] have determined the position of the tape as one relevant factor impacting the surgical outcome. Some works, however, negate such relevance [10, 11]. Various approaches for measuring the position of the tape by means of ultrasound have been proposed in the literature.…”

Section: Introductionmentioning

confidence: 99%

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Tomographic Ultrasound Imaging to Control the Placement of Tension-Free Transobturator Tape in Female Urinary Stress Incontinence

Graf

Kupec

Stickeler

et al. 2016

BioMed Research International

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Purpose. The objective was to evaluate, by means of tomographic ultrasound imaging (TUI), the reliability of a novel approach for determining the position of the implanted tension-free transobturator tape (TOT). Furthermore, we analyzed the association between the position of the tape at rest and the subjective cure in stress incontinent women. Methods. This retrospective pilot study consists of 32 stress incontinent women, who underwent TOT procedure and routine sonographic control at day 1 postoperatively and at follow-up visit. TUI was applied on the resulting 4D volumes, thereby delivering 9 axial slices with a 4 mm interslice distance starting at the meatus urethrae internus in caudal direction. The reliability of the approach was tested by two examiners. Postoperative and follow-up ultrasound parameters of uncured and cured patients were analyzed. Results. Measurements of the position of the TOT demonstrated high intraclass correlation coefficients. We found minor differences between sonographic parameters at day 1 postoperatively and at follow-up after a median period of 321 days. In cured patients, the position of the tape was measured in a more caudal position than in uncured patients. Conclusions. TUI can be a reliable method for determining the position of the tape. Further studies are needed to evaluate whether the postoperatively determined position can be used as an indicator of future subjective cure.

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“…the angle between the cranial and caudal aspects of the sling, or the ‘sling‐pubis gap’ i.e. the shortest distance between sling and posterior surface of the pubis on Valsalva 31 (Figure 5). The latter appears to be a more valid parameter of sling ‘tightness’.…”

Section: Methodsmentioning

confidence: 99%

Imaging of slings and meshes

Shek

Dietz

2014

Australas J Ultrason Med

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The popularity of imaging in pelvic floor medicine continues to increase. Among the various modalities, ultrasound is superior as it is cheap, safe, easily accesible and simple, resulting in high patient compliance. It is the only technique that allows imaging of modern wide‐weave polypropylene sling or mesh implants, and imaging of such implants is commonly required due to the popularity of surgical techniques that involve the placement of slings and meshes. This review article will discuss the role of translabial ultrasound in the evaluation of synthetic implants used in the treatment of urinary incontinence and pelvic organ prolapse.

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Sonographic appearance of transobturator slings: implications for function and dysfunction

Abstract: A narrower gap between the tape and symphysis pubis is associated with both SI and UI cure. Tighter transobturator sling placement seems to be advantageous for the cure of both SI and UI.

Cited by 85 publications

References 17 publications

The effectiveness of a pre-pubic four-arm NAZCA-TC mesh in treating cystocele and stress urinary incontinence simultaneously — results controlled with a pelvic floor ultrasound. A preliminary study

The effectiveness of a pre-pubic four-arm NAZCA-TC mesh in treating cystocele and stress urinary incontinence simultaneously — results controlled with a pelvic floor ultrasound. A preliminary study

Tomographic Ultrasound Imaging to Control the Placement of Tension-Free Transobturator Tape in Female Urinary Stress Incontinence

Imaging of slings and meshes

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