Association between sonographic sling location and success of surgery for stress urinary incontinence
Abstrakt
Objective: To determine the relationship between the clinical outcome of suburethral sling surgery for stress urinary incontinence and sling location on ultrasound examination. Methods: This was a retrospective study of patients diagnosed with stress urinary incontinence who were treated with a suburethral sling by a single surgeon between January 2009 and October 2016.
Four-dimensional volumes acquired on transperineal ultrasound at least 3 months postoperatively were analyzed and the gap between the sling and symphysis pubis (sling-pubis gap (SPG)) on Valsalva maneuver was measured. Continence was assessed on a cough stress test at follow-up.
Results: A total of 378 patients were included, with a mean follow-up of 14.3 months. The success rate of sling surgery was 89.4%.
The mean +- SD SPG on Valsalva maneuver was 12.0 +- 2.5 mm in women who were clinically continent at follow-up and 14.1 +- 2.8 mm in those with failed surgery (P < 0.001). Conclusion: A shorter SPG on transperineal ultrasound imaging after suburethral sling surgery is associated with cure of stress urinary incontinence.