Manabu Nishibayashi1, Koichi Kobayashi2, Akinori Miki2, Ryugo Okagaki2, Ichiro Nagata2, Mitsuyoshi Urashima3, Osamu Ishihara2. 1. Department of OB/GYN, Saitama Medical University, 38, Morohongo, Moroyama, Iruma, Saitama, 350-0495, Japan. manabun@f2.dion.ne.jp. 2. Department of OB/GYN, Saitama Medical University, 38, Morohongo, Moroyama, Iruma, Saitama, 350-0495, Japan. 3. Jikei Clinical Research and Development, Jikei University School of Medicine, Tokyo, Japan.
Abstract
PURPOSE: To study the correlation between stress urinary incontinence (SUI) and the mobility and funneling of the bladder neck (BN) by observation of pre- and postoperative course by perineal ultrasound (PUS). METHODS: We investigated 123 cases that underwent reconstructive surgery for pelvic organ prolapse (POP). We prospectively checked bladder neck mobility (BNM) during the Valsalva maneuver and funneling of the BN at rest by PUS. We defined the width multiplied by the depth of the funnel-like profile of the BN as the funneling index (FI). We checked BNM, FI, and the presence of SUI just before the operation, and we checked the postoperative course of BNM and SUI. RESULTS: When BNM was ≥10 mm before surgery, the odds ratio for accompanying SUI was 2.68 relative to BNM <10 mm (p = 0.031). When FI was ≥150 before surgery, the odds ratio for accompanying SUI was 4.12 relative to FI <150 (p = 0.004). Although postoperative BNM values were significantly improved immediately after surgery, they gradually increased within 2 years. Among the cases with preoperative SUI, the recurrence rate was significantly higher in the patients whose FI was <150 (p = 0.019). CONCLUSIONS: Our results yielded by PUS suggested that larger BNM and FI values were the causative factors of SUI. PUS may be beneficial for selecting a suitable surgical procedure for POP, and it may also be helpful for assessing surgical efficacy.
PURPOSE: To study the correlation between stress urinary incontinence (SUI) and the mobility and funneling of the bladder neck (BN) by observation of pre- and postoperative course by perineal ultrasound (PUS). METHODS: We investigated 123 cases that underwent reconstructive surgery for pelvic organ prolapse (POP). We prospectively checked bladder neck mobility (BNM) during the Valsalva maneuver and funneling of the BN at rest by PUS. We defined the width multiplied by the depth of the funnel-like profile of the BN as the funneling index (FI). We checked BNM, FI, and the presence of SUI just before the operation, and we checked the postoperative course of BNM and SUI. RESULTS: When BNM was ≥10 mm before surgery, the odds ratio for accompanying SUI was 2.68 relative to BNM <10 mm (p = 0.031). When FI was ≥150 before surgery, the odds ratio for accompanying SUI was 4.12 relative to FI <150 (p = 0.004). Although postoperative BNM values were significantly improved immediately after surgery, they gradually increased within 2 years. Among the cases with preoperative SUI, the recurrence rate was significantly higher in the patients whose FI was <150 (p = 0.019). CONCLUSIONS: Our results yielded by PUS suggested that larger BNM and FI values were the causative factors of SUI. PUS may be beneficial for selecting a suitable surgical procedure for POP, and it may also be helpful for assessing surgical efficacy.
Authors: R Tunn; G Schaer; U Peschers; W Bader; A Gauruder; E Hanzal; H Koelbl; D Koelle; D Perucchini; E Petri; P Riss; B Schuessler; V Viereck Journal: Int Urogynecol J Pelvic Floor Dysfunct Date: 2004-10-16
Authors: Roberto Pregazzi; Andrea Sartore; Paolo Bortoli; Eva Grimaldi; Luigi Troiano; Secondo Guaschino Journal: BJOG Date: 2002-07 Impact factor: 6.531