Robot-assisted laparoscopic hysterectomy and conventional laparoscopy compare well in most surgical aspects, but the robotic procedure is associated with longer operating times. Postoperative quality-of-life index was better; however, long-term, there was no difference. However, subjective postoperative parameters such as analgesic use and return to activity showed no significant difference between both groups.
Whereas in the past, defects of the vaginal attachment to the pelvic side wall could not be examined sonographically, 3D ultrasound can now be used to examine pelvic floor anatomy and to detect changes associated with trauma to the pelvic floor following vaginal delivery.
In the case of 81 patients, we conducted a perineal ultrasound and a lateral chain urethrocystography under standard conditions. The data collected were compared. The object of this prospective study was, to estimate the comparability of both methods. We also compared, whether the ultrasonically measured values were different between the supine and upright position. The measured values of both methods corresponded at rest, while during strain the values are different. During Valsalva's manoeuvre, the ultrasound method reflects the mobility of the bladder neck better, while the funnelling of the bladder neck can be examined better by lateral chain urethrocystography. The differences between the supine and upright positions were minor in the ultrasound examination, although the funnelling of the bladder neck could be detected better in the upright position. Our study shows that all important measured values can be collected with perineal ultrasound. Except for the funnelling of the bladder neck, typical findings of incontinence can be better shown with perineal ultrasound.
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