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Three-dimensional ultrasound assessment and middle term efficacy of a single-incision sling

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Abstract

Introduction and hypothesis

The aim of this study was to evaluate the functional outcome of a single-incision sling procedure for the treatment of female stress urinary incontinence (SUI) and to correlate the cure rate with a pelvic floor ultrasound examination

Methods

Fifty-seven patients treated with a single-incision sling procedure between January 2009 and September 2010 were included in the study. Functional outcome was evaluated as objective cure rate assessed with stress test and subjective cure rate determined by the International Consultation on Incontinence-Short Form and Patient Global Impression of Improvement scores. Women underwent perineal ultrasound examination by a combined 2D translabial and 3D transvaginal approach to assess bladder neck and tape mobility, tape position along the urethral axis, and tape anchorage. According to the position of self-fixating tips, we divided patients into group A (both tips crossed the obturator membrane), group B (only one tip crossed the obturator membrane) and group C (none of the tips crossed the obturator membrane). Objective cure rate and type of anchorage were compared with all ultrasound parameters.

Results

At an average follow-up of 13 months objective cure rate was 87.7 % with a significant subjective improvement. A significant difference in tape mobility was noted between group A and group C. Bladder neck mobility significantly increased in failures. Sling was significantly closer to mid-urethra in cured than in failures.

Conclusions

In 77 % of patients MA didn’t reach the obturator membrane on both sides. This feature conditioned significantly bladder neck mobility but not the efficacy of the procedure. Tape position seems to be the most important factor for success.

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Abbreviations

SUI:

Stress urinary incontinence

SIS:

Single incision sling

BMI:

Body mass index

TVT:

Tension-free vaginal tape

TOT:

Transobturator tape

ICIQ-SF:

International Consultation on Incontinence Questionnaire-Short Form

PGI-I:

Patient Global Impression of Improvement

ICIQ-UI-SF:

International Consultation on Incontinence Questionnaire-Short Form Italian validation

UJ:

Urethrovesical junction

ICS:

International Continence Society

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Acknowledgements

We want to express our gratitude to Dr Robert Fruscio for his kind and experienced help in reviewing the script.

Conflicts of interest

None.

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Authors and Affiliations

  1. Università Milano Bicocca, Azienda Ospedaliera San Gerardo, Monza, Italy

    Federico Spelzini

  2. Università Milano Bicocca, Milan, Italy

    Maria Cristina Cesana, Debora Verri, Serena Polizzi & Matteo Frigerio

  3. Azienda Ospedaliera San Gerardo, Università Milano Bicocca, Milan, Italy

    Rodolfo Milani

  4. Ginecologia Chirurgica, Ospedale San Gerardo, Via Pergolesi 33, 20900, Monza, Italy

    Federico Spelzini

Authors
  1. Federico Spelzini
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  2. Maria Cristina Cesana
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  3. Debora Verri
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  4. Serena Polizzi
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  5. Matteo Frigerio
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  6. Rodolfo Milani
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Corresponding author

Correspondence to Federico Spelzini.

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Spelzini, F., Cesana, M.C., Verri, D. et al. Three-dimensional ultrasound assessment and middle term efficacy of a single-incision sling. Int Urogynecol J 24, 1391–1397 (2013). https://doi.org/10.1007/s00192-012-2031-5

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  • DOI: https://doi.org/10.1007/s00192-012-2031-5

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