AIMS: This study assessed the effectiveness of ultrasound in determining tape distance to urethra and the impact of early tape mobilization on outcomes in women with postoperative voiding dysfunction resulting from a too tightly positioned tension-free vaginal tape (TVT). METHODS: A prospective observational study was conducted with women experiencing voiding dysfunction caused by too tightly positioned tapes. Ultrasound was used to identify the cause of the dysfunction and measure the distance between tape and longitudinal smooth muscle layer (LSM) of the urethra. If the tape was too close to the LSM (<3 mm) and the residual volume was >100 ml, it was mobilized under local/analgosedation shortly after the initial TVT procedure. RESULTS: Seventy-one postoperative TVT mobilization procedures were conducted on 61 women, which was 4.1% (61/1501) of all suburethral tape procedures performed. Early tape mobilization restored normal micturition in 59 (96.7%) of the women at the time of discharge. Significant differences were found in residual volumes (P < 0.001) and tape-LSM distances (P < 0.001) pre- and post-mobilization. At 6-month follow-up visits, 58 (95.1%) women were cured of SUI, three were incontinent, and no additional voiding dysfunction occurred. CONCLUSIONS: Immediate postoperative ultrasound can reliably detect too tightly positioned tapes that can be promptly treated with tape mobilization, a short and safe procedure that does not compromise the outcome of the original procedure.
AIMS: This study assessed the effectiveness of ultrasound in determining tape distance to urethra and the impact of early tape mobilization on outcomes in women with postoperative voiding dysfunction resulting from a too tightly positioned tension-free vaginal tape (TVT). METHODS: A prospective observational study was conducted with women experiencing voiding dysfunction caused by too tightly positioned tapes. Ultrasound was used to identify the cause of the dysfunction and measure the distance between tape and longitudinal smooth muscle layer (LSM) of the urethra. If the tape was too close to the LSM (<3 mm) and the residual volume was >100 ml, it was mobilized under local/analgosedation shortly after the initial TVT procedure. RESULTS: Seventy-one postoperative TVT mobilization procedures were conducted on 61 women, which was 4.1% (61/1501) of all suburethral tape procedures performed. Early tape mobilization restored normal micturition in 59 (96.7%) of the women at the time of discharge. Significant differences were found in residual volumes (P < 0.001) and tape-LSM distances (P < 0.001) pre- and post-mobilization. At 6-month follow-up visits, 58 (95.1%) women were cured of SUI, three were incontinent, and no additional voiding dysfunction occurred. CONCLUSIONS: Immediate postoperative ultrasound can reliably detect too tightly positioned tapes that can be promptly treated with tape mobilization, a short and safe procedure that does not compromise the outcome of the original procedure.
Authors: Jacek Kociszewski; Wojciech Majkusiak; Andrzej Pomian; Paweł Tomasik; Edyta Horosz; Andrzej Kuszka; Ewa Barcz Journal: Biomed Res Int Date: 2016-11-23 Impact factor: 3.411