Use of three-dimensional ultrasound scan to assess the clinical importance of midurethral placement of the tension-free vaginal tape (TVT) for ... View Full Text


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Article Info

DATE

2005-06

AUTHORS

Christopher C. M. Ng, L. C. Lee, William H. C. Han

ABSTRACT

The aim of the study is to illustrate that the midurethral positioning of the tension-free vaginal tape (TVT) may not be necessary to achieve continence. Our secondary aim is to highlight that a fair number of successfully performed TVT procedures do not result in midurethral position of the tape. A review of 31 women who underwent TVT operations and consecutively returned for their follow-up visits from July 2003 to November 2003 was conducted. Their TVT procedures were performed between March 2000 and August 2003. Transperineal three-dimensional ultrasound was used to identify and obtain objective measurements of the position of the TVT tape relative to the urethra. Any patients with significant coexisting vault or uterovaginal prolapse were surgically corrected at the same time. Their stress urinary incontinence was objectively diagnosed by performing urodynamic studies (dual-channel subtraction cystometry, erect stress test) in the outpatient urogynaecology clinic. Postoperatively, patients were reviewed at 1 month and then at 6 months followed by annual reviews subsequently. All women were reassessed at the 6-month follow-up visit with a filling and voiding cystometry to detect recurrent genuine stress incontinence and detrusor instability. Any woman complaining of stress urinary incontinence after that was reassessed with urodynamic studies as mentioned above. The majority of women (67.7%, 21 women) had the TVT tape located in the middle one-third of the urethra; 9.7% (3 women) and 22.6% (7 women) of women had the TVT tape situated in the proximal and distal one-third of the urethra, respectively. Despite this, all 31 women remained continent at their postoperative follow-up visits. The midurethral position of the TVT tape may not be essential in restoring continence. The TVT tape once inserted may not always rest in the midurethral position as described. More... »

PAGES

220-225

References to SciGraph publications

  • 1996-03. Recommendations of the german association of urogynecology on functional sonography of the lower female urinary tract in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 1998-07. A multicenter study of tension-free vaginal tape (TVT) for surgical treatment of stress urinary incontinence in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 1996-03. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2002-08. Urogynecologic Ultrasound is a Useful Aid in the Assessment of Female Stress Urinary Incontinence – A Prospective Study with TVT Procedure in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 1998-12. Anatomical assessment of the bladder outlet and proximal urethra using ultrasound and videocystourethrography in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2003-08. The effects of the tension-free vaginal tape on proximal urethral position: a prospective, longitudinal evaluation in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2002-04. TVT: On Midurethral Tape Positioning and its Influence on Continence in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2001-06. Long-term Results of the Tension-Free Vaginal Tape (TVT) Procedure for Surgical Treatment of Female Stress Urinary Incontinence in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2001-06. Tension-Free Vaginal Tape (TVT) in Women with Recurrent Stress Urinary Incontinence – A Long-term Follow up in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2001-06. Tension-Free Vaginal Tape (TVT) in Stress Incontinent Women with Intrinsic Sphincter Deficiency (ISD) – A Long-Term Follow-up in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 1996-05. Clinical outcome and changes in connective tissue metabolism after intravaginal slingplasty in stress incontinent women in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00192-004-1245-6

    DOI

    http://dx.doi.org/10.1007/s00192-004-1245-6

    DIMENSIONS

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    PUBMED

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