Correlation between changes in ultrasound measurements and clinical curative effect of tension-free vaginal tape-SECUR* procedure
- 97 Downloads
Introduction and hypothesis
The hypotheses of this study were that the TVT-SECUR procedure restricts urethral mobility, which leads to a greater likelihood of curative effect, and that the restriction might change over time.
Analyses of the position of the urethra and the tape of 85 patients who underwent the TVT-S procedure were performed using perineal ultrasonography. The efficacy of the TVT-S procedure was evaluated by cough test and by the questionnaire ICIQ-UI SF.
Objectively, 53/85 (62%) of patients had a negative cough test, and in 32/85 (38%) of patients leakage of urine persisted. The TVT-S procedure restricts urethral mobility, and a higher degree of obstruction is associated with a higher likelihood of cure. The restriction weakens within the first 3 months after surgery.
The objective cure rate of TVT-S procedure is low irrespective of placement technique. This may be due to insufficient restriction of urethral mobility.
KeywordsStress urinary incontinence TVT-S System Transperineal ultrasound
- ICIQ-UI SF
The International Consultation on Incontinence Questionnaire—Short Form
pelvic organ prolapse quantitative
tension-free obturator tape
stress urinary incontinence
tension-free vaginal tape
tension-free vaginal tape-SECUR system
This work was supported by the Grant Agency of the Ministry of Health of the Czech Republic, grant NR/9216-3
The first author is a TVT-SECUR preceptor for Ethicon Women’s Health and Urology.
- 8.Novara G, Galfano A, Boscolo-Berto R, Secco S, Cavalleri S, Ficarra V et al (2008) Complication rates of tension-free midurethral slings in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of randomized controlled trials comparing tension-free midurethral tapes to other surgical procedures and different devices. Eur Urol 53:288–308PubMedCrossRefGoogle Scholar
- 9.Rezapour M, Novara G, Meier PA, Holste J, Landgrebe S, Artibani W (2007) A 3-month preclinical trial to assess the performance of a new TVT-like mesh (TVTx) in a sheep model. Int Urogynecol J Pelvic Floor Dysfunct 18:173–182Google Scholar
- 13.Avery K, Donovan J, Abrams P (2001) Validation of a new questionnaire for incontinence: the international consultation on incontinence questionnaire (ICI-Q). Neurourol Urodyn 20:86Google Scholar
- 14.Donovan JL, Badia X, Corcos J, Gotoh M, Kelleher C, Naughton N et al (2002) Symptom and quality of life assessment. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence, 2nd Edit. Health, Bristol, pp 269–316Google Scholar
- 19.Schuettoff S, Beyersdorff D, Gauruder-Burmester A, Tunn R (2006) Visibility of polypropylene tape after tension-free vaginal tape (TVT) procedure in women with stress urinary incontinence: comparison of introital ultrasound and magnetic resonance imaging in vitro and in vivo. Ultrasound Obstet Gynecol 27:687–692PubMedCrossRefGoogle Scholar
- 21.Masata J, Martan A, Kasikova E, Halaska M, Voigt R, Drahoradova P (2002) Ultrasound study of the effect of TVT operation on the mobility of the whole urethra. Neurourol Urodyn 21:286–288Google Scholar
- 23.Thompson JA, O’Sullivan PB, Briffa NK, Neumann P (2007) Comparison of transperineal and transabdominal ultrasound in the assessment of voluntary pelvic floor muscle contractions and functional manoeuvres in continent and incontinent women. Int Urogynecol J Pelvic Floor Dysfunct 18:779–786PubMedCrossRefGoogle Scholar
- 25.DeTayrac R, Deffieux X, Resten A, Doumerc S, Ch Jouffroy, Fernandez H (2006) A transvaginal ultrasound study comparing transobturator tape and tension-free vaginal tape after surgical treatment of female stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 17:466–471CrossRefGoogle Scholar