Department of Gynecology and Obstetrics, Lutheran Hospital, Hagen-Haspe, Germany.
Ultrasound Obstet Gynecol. 2012 Feb;39(2):210-4. doi: 10.1002/uog.10050.
The tension-free vaginal tape (TVT) insertion technique generally does not take into account individual urethral length. In this study we investigated whether preoperative sonographic measurement of individual urethral length allows for reliable TVT positioning under the midurethra, which is a critical segment for the continence mechanism.
Urethral length was measured by preoperative introital ultrasonography in 102 consecutive female patients with stress urinary incontinence. TVT procedures were performed as recommended by the manufacturer. The suburethral incisions were initiated at one-third of the sonographically measured urethral length. TVT position and tape-urethra distance were followed up 6 months postoperatively.
At 6-month examination 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-longitudinal smooth muscle distance had a greater likelihood of being cured without complications (P < 0.001).
Preoperative sonographic measurement of urethral length, combined with the one-third rule, may aid in reliable midurethral TVT positioning.
经阴道无张力吊带（TVT）的插入技术通常不考虑个体尿道长度。在本研究中，我们研究了术前超声测量个体尿道长度是否可以在尿道中段可靠定位，这是控尿机制的关键部位。
102 例压力性尿失禁女性患者术前经阴道超声测量尿道长度。按照制造商的建议进行 TVT 手术。在超声测量的尿道长度的三分之一处开始进行尿道下切开。术后 6 个月随访 TVT 位置和吊带-尿道距离。
在 102 名研究参与者的 6 个月检查中，93.1%的患者治愈，6.9%的患者控尿改善。在队列的 88.2%中，TVT 位于尿道长度的 50-70%的目标范围内。TVT 位于尿道长度的 50-70%范围内且吊带-纵行平滑肌距离为 3-5mm 的女性，无并发症治愈的可能性更大（P<0.001）。
术前超声测量尿道长度，结合三分之一规则，可能有助于可靠的尿道中段 TVT 定位。
