Anatomic Course of the Ureter in Relation to Vertebral and Vascular Landmarks on Computed Tomography

Abstract

subdivided into four categories: voiding disorders, storage/irritative disorders, extrusion/erosion, and other. Cure was defined as complete resolution of all symptoms, whereas improvement was some resolution of symptoms but not complete cure. Data was evaluated by descriptive statistics and inference analysis. Results: Of the 28 patients that underwent a MUS revision, 26 (93%) were reviewed. The most common preoperative symptoms included irritative disorders (73.1%), voiding difficulties (57.7%), urge incontinence (50%), vaginal/pelvic pain (42.3%), stress urinary incontinence (34.6%), sling extrusion (23.1%), and recurrent urinary tract infection (23.1%). Two patients had sling erosions. Many patients had more than one symptom. Overall, 46.1% of patients were cured and 69.2% had resolution in at least 50% of all their symptoms. By category, sling extrusion was cured in 88.9% of patients; voiding dysfunction in 88.2%; and storage/irritative disorders in 31.5% of patients. When broken down into specific symptoms, in patients with urgency and urge incontinence, 27.3% and 46.2% had resolution of symptoms respectively, while 3 patients developed de novo urgency/urge incontinence. Stress incontinence resolved in 77.8% of patients, and there were no cases of de novo SUI. There were no cases of recurrent sling extrusion. In 66.7% of cases with recurrent urinary tract infection, the recurrence resolved; 2 patients developed de novo RUTI. When surgical technique was compared, 61.5% of cases had a sling revision only, 30.8% had sling revision plus pelvic floor surgery, and 7.7% had sling revision plus anti-incontinence procedure. Sling revision surgical techniques included sling transection (41.6%), incomplete resection (34.6%), complete resection (11.5%), and excision of sling from urethra and bladder (7.7%). No intraoperative complications occurred. When the researchers compared previous type of sling used, time to sling revision, and type of sling revision performed, there was no statistically significant difference seen in any of these variables between those subjects who had resolution of symptoms and those who did not (p \ 0.05). Conclusion: