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

Abstract

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.

Do the Ultrasonographic Measures of Midurethral Sling Location Relate With Surgical Outcomes?

“…Besides, ultrasonography may also be used intraoperatively to optimize sling position; indeed, 1 recent study has reported that the use of intraoperative ultrasonography for the placement of the MUS allows one to position the sling optimally and avoid erroneous placements. 32 However, further studies are needed.…”

“…According to the results of our study, ultrasonographic evaluation of the MUS location seemed to be an important diagnostic tool, which may be considered in the clinical evaluation of women who were not satisfied after MUS surgery. Besides, ultrasonography may also be used intraoperatively to optimize sling position; indeed, 1 recent study has reported that the use of intraoperative ultrasonography for the placement of the MUS allows one to position the sling optimally and avoid erroneous placements 32 . However, further studies are needed.…”