The role of urethral hypermobility and intrinsic sphincteric deficiency on the outcome of transobturator tape procedure: a prospective study with 2-year follow-up

Haliloğlu, Berna; Karateke, Ateş; Çoksüer, Hakan; Peker, Hakan; Çam, Çetin

doi:10.1007/s00192-009-1010-y

Cited by 48 publications

(32 citation statements)

References 18 publications

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“…This type of analysis seeks to circumvent selection bias, as analyzing urethral mobility or VLPP singly. A contemporary Turkish study had a similar conclusion (21).…”

Section: Discussionmentioning

confidence: 57%

Prognostic value of urethral mobility and valsalva leak point pressure for female transobturator sling procedure

Toledo¹,

Cabral²,

Casella³

et al. 2012

Int. braz j urol.

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ARTICLE INFO _________________________________________________________ ___________________Purpose: To analyze the influence of urethral mobility and Valsalva leak point pressure on postoperative outcomes of transobturator sling (TOT) for female stress urinary incontinence. Materials and Methods: A prospective cohort was conducted including 66 patients submitted to TOT from March 2006 to May 2009. Urethral hypermobility was defined as mobility ≥ 30º on Q-tip test, and Valsalva leak point pressure (VLPP) was classified as greater than 60 cmH 2 O or 60 and less on preoperative urodynamics. These parameters were compared through well defined postoperative objective and subjective success criteria. Intensity of urinary leakage and quality of life was analysed by ICIQ-SF. Statistical analysis was accomplished and the results rendered significant if p < 0.05. Results: Mean follow up was 10 months (3 to 28). Mean age was 55 years (33 to 80), 70% were white and 30% African descendent, mean body mass index was 27 (21 to 38), average vaginal and abdominal deliveries were 2.8 and 0.5 respectively. A quarter had prior stress incontinence surgery. Patients with urethral hypermobility had higher objective success rates (98% versus 81.25%, p = 0.04). The subjective success rate was also greater in the hypermobility group (84% versus 62.5%), but statistical significance was not reached (p = 0.07). VLPP had no influence on either objective or subjective postoperative success rates (p = 0.17 and 0.34, respectively). In the subgroup analysis, those with low mobility and high VLPP had worse objective success rates in comparison to the group with hypermobility and low VLPP (p = 0.04) and also in relation to the remaining of the studied population. Other possible prognostic factors (previous surgery, mixed incontinence, gestational status) had no influence on success rates. Conclusions: High urethral mobility, regardless of the sphincteric status indicated by VLPP, is a favorable prognostic factor for tension-free transobturator tape procedure. No relationship was demonstrated between postoperative success rates and VLPP.

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“…This type of analysis seeks to circumvent selection bias, as analyzing urethral mobility or VLPP singly. A contemporary Turkish study had a similar conclusion (21).…”

Section: Discussionmentioning

confidence: 57%

Prognostic value of urethral mobility and valsalva leak point pressure for female transobturator sling procedure

Toledo¹,

Cabral²,

Casella³

et al. 2012

Int. braz j urol.

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“…The underlying pathology has been postulated to involve urethral hypermobility [5], intrinsic urethral sphincter deficiency [5] or any disturbance within the sphincter mechanism [6,7].…”

Section: Introductionmentioning

confidence: 99%

Intraobserver and interobserver reliability of the three-dimensional ultrasound imaging of female urethral sphincter using a translabial technique

et al. 2012

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The described technique using multiple axial cross-sectional areas at set distances and a translabial approach is a reliable and accurate tool in the evaluation of the urethral sphincter. This should be used instead of mathematical formulas as the urethral sphincter is not a uniform geometrical sphere. The technique and values reported may help clinicians in the assessment of women with lower urinary tract disorders.

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“…The type of urinary incontinence determines choice of surgical treatment, to prevent UH by repositioning the urethra into the pelvis to equalize pressure trans mission between the bladder and urethra, and for women with low urethral resistance in ISD to increase the urethral closure pressures. Studies investigating the effects of UH and ISD on the outcome of the commonly performed procedures, such as transobturator tape (TOT) used to treat UH reported that the lack of UH as a contributing factor to SUI may be a risk factor for TOT failure [4] . Also, Sand et al [5] studied women who failed retropubic suspension and found a higher failure rate in those with ISD.…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging in assessment of stress urinary incontinence in women: Parameters differentiating urethral hypermobility and intrinsic sphincter deficiency

Macura

Thompson

Bluemke

et al. 2015

WJR

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AIM:To define the magnetic resonance imaging (MRI) parameters differentiating urethral hypermobility (UH) and intrinsic sphincter deficiency (ISD) in women with stress urinary incontinence (SUI). METHODS:The static and dynamic MR images of 21 patients with SUI were correlated to urodynamic (UD) findings and compared to those of 10 continent controls. For the assessment of the urethra and integrity of the urethral support structures, we applied the highresolution endocavitary MRI, such as intraurethral MRI, endovaginal or endorectal MRI. For the functional imaging of the urethral support, we performed dynamic MRI with the pelvic phased array coil. We assessed the following MRI parameters in both the patient and the

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The role of urethral hypermobility and intrinsic sphincteric deficiency on the outcome of transobturator tape procedure: a prospective study with 2-year follow-up

Abstract: A lack of urethral hypermobility may be a risk factor for TOT failure.

Cited by 48 publications

References 18 publications

Prognostic value of urethral mobility and valsalva leak point pressure for female transobturator sling procedure

Prognostic value of urethral mobility and valsalva leak point pressure for female transobturator sling procedure

Intraobserver and interobserver reliability of the three-dimensional ultrasound imaging of female urethral sphincter using a translabial technique

Magnetic resonance imaging in assessment of stress urinary incontinence in women: Parameters differentiating urethral hypermobility and intrinsic sphincter deficiency

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