Department of Ultrasound, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China.
Int Urogynecol J. 2022 Oct;33(10):2849-2857. doi: 10.1007/s00192-021-05014-3. Epub 2022 Jan 11.
The aim of this study was to investigate the relationship between compression effect exerted by the sling on the urethra using translabial ultrasound and the prognosis of sling surgery in women for stress urinary incontinence (SUI).
We retrospectively reviewed 151 women with SUI who had undergone either a TVT-Abbrevo (n = 81) or TVT-O (n = 70) procedure. Preoperative and 12-month postoperative assessments including sonographic data, urinary symptoms and signs were compared. Objective and subjective success rates were assessed at 12 months postoperatively.
Overall, 140 patients (92.7%) were objectively cured and 138 patients (91.4%) were subjectively cured of SUI 12 months after the operation with no significant differences between groups (p > 0.05). After both the TVT-Abbrevo and TVT-O procedures, the shortest distance between the tape and the urethral cavity line (TU) on straining (objective cure 4.1 mm vs. 4.5 mm, subjective cure 4.1 mm vs. 4.4 mm), the changes of the angle (∆) between the two arms of the sling (objective cure 15.8° vs. 20.8°, subjective cure 16.5° vs. 21.3°) and the gap between the sling and symphysis pubis (objective cure 9.9 mm vs. 12.1 mm, subjective cure 9.8 mm vs. 12.4 mm) were significantly smaller in the success group (p < 0.05). Analysis of ultrasound measurements in women reporting success and those reporting failure of the procedure showed the ∆TU (objective cure 1.6 mm vs. 0.9 mm, subjective cure 1.6 mm vs. 1.0 mm) and the angle on straining (objective cure 93.4° vs. 89.2°, subjective cure 94.3° vs. 88.9°) to be significantly bigger (p < 0.05). However, none of the assessed sonographic variables showed any significant differences between the TVT-Abbrevo and TVT-O groups.
The change in distance between the tape and urethral cavity line in the center of the urethra in the mid-sagittal plane after straining is an effective indicator of the compression effect exerted by the sling on the urethra after a mid-urethral sling (MUS) procedure and may contribute to both objective and subjective cure rates postoperatively.
本研究旨在探讨经阴道超声(translabial ultrasound, TVUS)测量吊带对尿道的压迫效果与女性压力性尿失禁(stress urinary incontinence, SUI)吊带手术预后的关系。
我们回顾性分析了 151 例接受 TVT-Abbrevo(n=81)或 TVT-O(n=70)手术的 SUI 女性患者的资料。比较术前和术后 12 个月的超声数据、尿症状和体征。术后 12 个月评估客观和主观成功率。
总体而言，140 例患者(92.7%)术后 12 个月客观治愈，138 例患者(91.4%)主观治愈，两组间无显著差异(p>0.05)。TVT-Abbrevo 和 TVT-O 手术后，尿道腔内线(urethral cavity line, TU)上吊带最短距离(客观治愈 4.1mm vs. 4.5mm，主观治愈 4.1mm vs. 4.4mm)、吊带两臂夹角变化(客观治愈 15.8° vs. 20.8°，主观治愈 16.5° vs. 21.3°)和吊带与耻骨联合间隙(ob-jective cure 9.9mm vs. 12.1mm，subjective cure 9.8mm vs. 12.4mm)在成功组中显著较小(p<0.05)。对手术成功和失败的患者进行超声测量分析显示，△TU(客观治愈 1.6mm vs. 0.9mm，主观治愈 1.6mm vs. 1.0mm)和尿道受力时的夹角(客观治愈 93.4° vs. 89.2°，主观治愈 94.3° vs. 88.9°)显著更大(p<0.05)。然而，在 TVT-Abbrevo 和 TVT-O 两组之间，没有一个评估的超声变量显示出任何显著差异。
尿道中段吊带术后尿道中段正中矢状面尿道腔内线上吊带与尿道腔的距离变化是吊带对尿道压迫效果的有效指标，可能有助于术后客观和主观治愈率。
