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

Abstract

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.

Treatment of Male Stress Urinary Incontinence with A Fixed Sling Made of PVDF - 6-Year Follow-Up Data

“…The present study adds to the growing body of literature showing that PVDF is a safe and effective sling material in pelvic floor surgery [30][31][32][33][34]. Importantly, the study provides long-term data that is critical for the evaluation of patient safety and device performance in the long run.…”

ACR Appropriateness Criteria® Pelvic Floor Dysfunction in Females

“…TPUS is more sensitive for locating mesh and sling material compared with physical examination and urethrocystoscopy [112]. TPUS with tomographic reconstructions has been used to assess the location of midurethral slings after surgery [113]. Anterior and posterior components of sacrocolpopexy vaginal mesh can be seen with TPUS; however, evaluation of apical and cranial components of the sacrocolpopexy mesh is limited on TPUS [114].…”

Translabial ultrasound evaluation after tension‐free transobturator tape technique: Outcomes based on the tape's position

“…Various approaches for measuring the position of the tape using ultrasound (transabdominal, transvaginal, perineal) have been proposed in the recent literature, such as the tape‐symphysis pubis angle and sagittal tape‐symphysis pubis distance. 11 , 14 However, data on the topic are still limited and the sonographic measures proposed are often difficult and less reproducible. Since 1990, translabial ultrasound (TL‐US) has been used as a useful technique in the lower urogenital tract.…”