Correlations between Sonographic and Urodynamic Findings after Mid Urethral Sling Surgery

No AccessJournal of UrologyAdult Urology1 Jun 2018Correlations between Sonographic and Urodynamic Findings after Mid Urethral Sling Surgery Lieming Wen, Ka Lai Shek, Nishamini Subramaniam, Talia Friedman, and Hans Peter Dietz Lieming WenLieming Wen Second Xiangya Hospital, Central South University, Changsha Huna, China , Ka Lai ShekKa Lai Shek Liverpool Clinical School, Western Sydney University, Liverpool, New South Wales, Australia Nepean Clinical School, University of Sydney, Kingswood, New South Wales, Australia , Nishamini SubramaniamNishamini Subramaniam Nepean Clinical School, University of Sydney, Kingswood, New South Wales, Australia , Talia FriedmanTalia Friedman Nepean Clinical School, University of Sydney, Kingswood, New South Wales, Australia , and Hans Peter DietzHans Peter Dietz Nepean Clinical School, University of Sydney, Kingswood, New South Wales, Australia View All Author Informationhttps://doi.org/10.1016/j.juro.2017.12.046AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We studied correlations between sonographic and urodynamic findings after suburethral sling surgery. Materials and Methods: This retrospective study was done in 141 women who underwent multichannel urodynamic testing and translabial 4-dimensional ultrasound after suburethral sling surgery between 2006 and 2016. We determined the sling-pubis gap, ie the distance between the sling and the inferior posterior margin of the pubic symphysis, during the Valsalva maneuver and the urethral motion profile. The latter was assessed by calculating the mobility vectors of 6 equidistant points along the length of the urethra from the bladder neck to the external urethral meatus against the dorsocaudal margin of the pubic symphysis during the Valsalva maneuver. Correlations were determined between the sling-pubis gap and the mobility vectors, and between these measures and urodynamic data. Results: Median followup in the 126 women with complete data was 36 months. Significant correlations were found between the sling-pubis gap and the mid urethral mobility vectors (all p <0.02). The sling-pubis gap and the mid urethral mobility vectors negatively correlated with detrusor pressure at maximum flow (p = 0.037 and 0.004, respectively). Urodynamic stress incontinence was more likely in women with a greater sling-pubis gap (p = 0.003). Conclusions: The tighter the sling on ultrasound, the less likely is urodynamic stress incontinence and the higher the detrusor pressure during voiding. References 1 : Mid-urethral sling operations for stress urinary incontinence in women. Cochrane Database Syst Rev2017; : CD006375. Google Scholar 2 : Urethral mobility and urinary incontinence. Ultrasound Obstet Gynecol2010; 36: 507. Google Scholar 3 : The urethral motion profile before and after Monarc suburethral sling placement. J Urol2010; 183: 1450. Link, Google Scholar 4 : The 'iris effect': how two-dimensional and three-dimensional ultrasound can help us understand anti-incontinence procedures. Ultrasound Obstet Gynecol2004; 23: 267. 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Google Scholar © 2018 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 199Issue 6June 2018Page: 1571-1576 Advertisement Copyright & Permissions© 2018 by American Urological Association Education and Research, Inc.Keywordsurinary incontinenceultrasonographypelvic organ prolapseurodynamicssuburethral slingsMetricsAuthor Information Lieming Wen Second Xiangya Hospital, Central South University, Changsha Huna, China More articles by this author Ka Lai Shek Liverpool Clinical School, Western Sydney University, Liverpool, New South Wales, Australia Nepean Clinical School, University of Sydney, Kingswood, New South Wales, Australia More articles by this author Nishamini Subramaniam Nepean Clinical School, University of Sydney, Kingswood, New South Wales, Australia More articles by this author Talia Friedman Nepean Clinical School, University of Sydney, Kingswood, New South Wales, Australia More articles by this author Hans Peter Dietz Nepean Clinical School, University of Sydney, Kingswood, New South Wales, Australia More articles by this author Expand All Advertisement PDF downloadLoading ...