Department of Gynecology and Obstetrics, Lutheran Hospital Hagen-Haspe, Germany.
The tension-free vaginal tape (TVT) insertion technique generally does not take into account individual urethral length. This study investigates whether preoperative sonographic measurement of individual urethral length allows for reliable TVT positioning under the mid-urethra - a critical segment for the continence mechanism.
Urethral length was measured by preoperative introital ultrasound in 102 consecutive female patients with stress urinary incontinence. TVT procedures were performed as recommended by the manufacturer. The suburethral incisions were initiated at 1/3 of the sonographically measured urethral length. TVT position and tape-urethra distance were followed up 6 months postoperatively.
At six month examinations of the 102 study participants 93.1% were cured and 6.9% showed improved continence. TVTs were found in the target range of 50%-70% of the urethral length in 88.2% of the cohort. Women with the TVT in the 50%-70% urethral length range and a 3-5 mm tape-LSM distance had a greater likelihood of being cured without complications (p< 0.001).
Preoperative sonographic measurement of the urethral length, combined with the 1/3 rule, may aid in reliable midurethral TVT positioning.
Written by:
Kociszewski J, Rautenberg O, Kuszka A, Eberhard J, Hilgers R, Viereck V. Are you the author?
Reference: Ultrasound Obstet Gynecol. 2011 Jul 26:132.
doi: 10.1002/uog.10050
PubMed Abstract
PMID: 21793084
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