Classification of descent and mobility of urethrovesic junction in women with stress urinary incontinence – an ultrasound study
Authors:
T. Výtisková 1; J. Mašata 2; K. Švabík 2; P. Hubka 2
; A. Martan 2
Authors‘ workplace:
Gynekologicko-porodnické oddělení, Thomayerova nemocnice, Praha, primář MUDr. P. Kolek
1; Gynekologicko-porodnická klinika VFN a 1. LF UK, Praha, přednosta prof. MUDr. A. Martan, DrSc.
2
Published in:
Ceska Gynekol 2018; 83(3): 188-194
Overview
Objective:
Detect urethrovesical junction descent and mobility values in women with stress incontinence prior to surgical treatment.
Design:
Retrospective study.
Settings:
Department of Gynecology and Obstetrics, First Medical Faculty, Charles University, General Teaching Hospital, Prague.
Methods:
A retrospective study included 568 patients from three different prospective studies. We have ultrasound data in 560 of them. All of these patients underwent surgical treatment of stress incontinence. During the preoperative examination, patients were subjected to clinical, urodynamic and ultrasound examinations, in which we focused on the urethrovesical junction descent and mobility rate in the maximal Valsav‘s maneuver. Statistical evaluation of the data was performed by a pair t-test or Wilcoxon test.
Results:
The mean dorsocaudal descent of the urethrovesical junction was 20.6 mm (SD 8.2, first quantile 14.9, third quantile 25.6 mm). We did not find any statistically significant differences in the acquired parameters at different time periods.
Conclusion:
Due to the high variability of urethrovesical junction descent and mobility, ultrasound examination should be part of all urogynecological preoperative examinations to provide the operator with information on urethrovesical junction descent and mobility prior to surgery and then compare it with postoperative results.
Keywords:
descent of the urethrovesical junction, mobility of urethrovesical junction, urethrovesical junction, incontinence, stress urinary incontinence, transperineal ultrasound
Sources
1. Bhatia, NN., Ostergard, DR., McQuown, D. Ultrasonography in urinary incontinence. Urology, 1987, 29, p. 90–94.
2. Dietz, H., Mouritsen, L., Ellis, G., et al. Does the tension-free vaginal tape stay where you put it? Am J Obstet Gynecol, 2003, 188, 4, p. 950–953.
3. Dietz, HP., Wilson, PD. Colposuspension success and failure: a long-term objective follow-up study. Int Urogynecol J Pelvic Floor Dysfunct, 2000, 11, 6, p. 346–351.
4. Dietz, HP., Clarke, B., Herbison, P. Bladder neck mobility and urethral closure pressure as predictors of genuine stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct, 2002, 13, 5, p. 289–293.
5. Haylen, BT., de Ridder, D., Freeman, RM., et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J Pelvic Floor Dysfunct, 21, 1, p. 5–26.
6. Haylen, BT., de Ridder, D., Freeman, RM., et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn, 2010, 29, 1, p. 4–20.
7. Lemack, GE., Litman, HJ., Nager, C., et al. Preoperative clinical, demographic, and urodynamic measures associated with failure to demonstrate urodynamic stress incontinence in women enrolled in two randomized clinical trials of surgery for stress urinary incontinence. Int Urogynecol J, 2013, 24, 2, p. 269–274.
8. Long, C., Hsu, C., Lo, T., et al. Ultrasonographic assessment of tape location following tension-free vaginal tape and transobturator tape procedure. Acta Obstet Gynecol Scand, 2008, 87, 1, p. 116–121.
9. Lukacz, E., Luber, K., Nager, C. The effects of the tension-free vaginal tape on voiding function: a prospective evaluation. Int Urogynecol J Pelvic Floor Dysfunct, 2004, 15, 1, p. 32–38, discussion 38.
10. Martan, A., Drbohlav, P., Mašata, M., et al. Změny uložení uretry a hrdla močového měchýře v těhotenství a po porodu. Čes Gynek, 1996, 61, 1, s. 35–39.
11. Martan, A., Mašata, M., Halaška, M. Ultrazvukové vyšetření dolního močového ústrojí u žen. Čes Gynek, 1997, 62, 6, s. 350–352.
12. Martan, A., Mašata, J., Halaška, M., et al. Změny v uložení uretrovezikální junkce v průběhu maximální volní kontrakce a v průběhu maximální vaginální elektrické stimulace svalů pánevního dna. Čes Gynek, 1998, 63, 3, s. 186–188.
13. Martan, A., Mašata, J., Halaška, M., et al. Ultrazvukové zobrazení dolního močového ústrojí u postmenopauzálních žen se stresovým či kombinovaným typem inkontinence moči před a po intravaginální aplikaci estriolu (Ovestinu). Čes Gynek, 1999, 64, 1, s. 6–9.
14. Martan, A., Mašata, J., Halaška, M., et al. Ultrazvukové hodnocení paravaginálního defektu před a po operační léčbě u žen se stresovým typem inkontinence moči. Čes Gynek, 2000, 65, 3, s. 152–156.
15. Martan, A., Mašata, J., Halaška, M., et al. Vliv náplně močového měchýře u žen se stresovým typem inkontinence moči na změny ultrazvukových parametrů dolního močového ústrojí. Čes Gynek, 2000, 65, 1, s. 10–13.
16. Martan, A., Mašata, J., Halaška, M., et al. Ultrasound imaging of the lower urinary system in women after Burch colposuspension. Ultrasound Obstet Gynecol, 2001, 17, 1, p. 58–64.
17. Martan, A., Mašata, J., Halaška, M. Inkontinence moči a ultrazvukové vyšetření dolního močového ústrojí u žen. PanMed, Praha, 2001, 190.
18. Martan, A., Mašata, J., Halaška, M., et al. Ultrasound imaging of paravaginal defects in women with stress incontinence before and after paravaginal defect repair. Ultrasound Obstet Gynecol, 2002, 19, 5, p. 496–500.
19. Martan, A., Petri, E., Mašata, J., et al. The effect of increasing intra-abdominal pressure on the position of the bladder neck in ultrasound imaging. Geburtshilfe Und Frauenheilkunde, 2002, 62, 1, p. 37–41.
20. Martan, A., Mašata, J., Švabík, K., et al. Curative effect of tension-free vaginal tape secur* procedure – correlation with changes in ultrasound measurements. Inter Urogynecol J, 2009, 20, 008.
21. Mašata, J., Martan, A., Švabík, K., et al. Změny vezikalizace uretry a močového měchýře po TVT operaci. Čes Gynek, 2005, 70, 4, s. 276–280.
22. Mašata, J., Martan, A., Švabík, K., et al. Změny mobility uretry po TVT operaci. Čes Gynek, 2005, 70, 3, s. 220–225.
23. Mašata, J., Švabík, K., Martan, A., et al. Který z ultrazvukových parametrů je optimální při vyšetření uložení a mobility uretrovezikální junkce? Čes Gynek, 2005, 70, 4, s. 280–285.
24. Mašata, J., Martan, A., Švabík, K., et al. Ultrasound imaging of the lower urinary tract after successful tension-free vaginal tape (TVT) procedure. Ultrasound Obstet Gynecol, 2006, 28, 2, p. 221–228.
25. Mašata, J., Martan, A., Švabík, K. Severe bleeding from internal obturator muscle following tension-free vaginal tape Secur hammock approach procedure. Int Urogynecol J Pelvic Floor Dysfunct, 2008, 19, 11, p. 1581–1583.
26. Mašata, J., Švabík, K., Martan, A. Ultrazvuk v urogynekologii. Čes Gynek, 2012, 77, 4, s. 292–298.
27. Mašata, J., Dundr, P., Martan, A. Actinomyces infection appearing five years after trocar-guided transvaginal mesh prolapse repair. Int Urogynecol J, 2014, 25, 7, p. 993–996.
28. Mašata, J., Švabík, K., Martan, A. Bleeding complication with the TVT-Exact procedure: a report of two cases. Int Urogynecol J, 2015, 26, 2, p. 303–305.
29. Nager, CW., Brubaker, L., Litman, HJ., et al. A randomized trial of urodynamic testing before stress-incontinence surgery. N Engl J Med, 2012, 366, 21, p. 1987–1997.
30. Ostrzenski, A., Osborne, NG., Ostrzenska, K. Method for diagnosing paravaginal defects using contrast ultrasonographic technique. J Ultrasound Med, 1997, 16, 10, p. 673–677.
31. Ostrzenski, A., Osborne, NG. Ultrasonography as a screening tool for paravaginal defects in women with stress incontinence: a pilot study. Int Urogynecol J Pelvic Floor Dysfunct, 1998, 9, 4, p. 195–199.
32. Rušavý, Z., Mašata, J., Švabík, K., et al. Are the same tapes really the same? Ultrasound study of laser-cut and mechanically cut TVT-O post-operative behavior. Int Urogynecol J, 2017.
33. Schaer, G., Koelbl, H., Voigt, R., et al. Recommendations of the German Association of Urogynecology on functional sonography of the lower female urinary tract. Int Urogynecol J Pelvic Floor Dysfunct, 1996, 7, 2, p. 105–108.
34. Schierlitz, L., Dwyer, PL., Rosamilia, A., et al. Effectiveness of tension-free vaginal tape compared with transobturator tape in women with stress urinary incontinence and intrinsic sphincter deficiency: a randomized controlled trial. Obstet Gynecol, 2008, 112, 6, p. 1253–1261.
35. Švabík, K., Martan, A., Mašata, J., et al. Změny délky implantované síťky po rekonstrukčním výkonu přední stěny poševní. Čes Gynek, 2010, 75, 2, s. 132–135.
36. Tunn, R., Schaer, G., Peschers, U., et al. Updated recommendations on ultrasonography in urogynecology. Int Urogynecol J Pelvic Floor Dysfunct, 2005, 16, 3, p. 236–241.
37. van Leijsen, SA., Mengerink, BB., Kluivers, KB. Urodynamics before stress urinary incontinence surgery. Curr Opin Obstet Gynecol, 2014, 26, 5, p. 398–403.
38. Viereck, V., Nebel, M., Bader, W., et al. Role of bladderneck mobility and urethral closure pressure in predicting outcome of tension-free vaginal tape (TVT) procedure. Ultrasound Obstet Gynecol, 2006, 28, 2, p. 214–220.
39. Viereck, V., Pauer, HU., Hesse, O., et al. Urethral hypermobility after anti-incontinence surgery – a prognostic indicator? Int Urogynecol J Pelvic Floor Dysfunct, 2006, 17, 6, p. 586–592.
40. Viereck, V., Kuszka, A., Rautenberg, O., et al. Do different vaginal tapes need different suburethral incisions? The one-half rule. Neurourol Urodyn, 2015, 34, 8, p. 741–746.
41. White, RD., McQuown, D., McCarthy, TA., et al. Real-time ultrasonography in the evaluation of urinary stress incontinence. Am J Obstet Gynecol, 1980, 138, 2, p. 235–237.
42. Wlazlak, E., Viereck, V., Kociszewski, J., et al. Role of intrinsic sphincter deficiency with and without urethral hypomobility on the outcome of tape insertion. Neurourol Urodyn, 2017, 36, 7, p. 1910–1916.
43. Zimmern, P., Litman, H., Nager, C., et al. Pre-operative urodynamics in women with stress urinary incontinence increases physician confidence, but does not improve outcomes. Neurourol Urodyn, 2014, 33, 3, p. 302–306.
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