Cross-sectional imaging following surgical interventions for stress urinary incontinence in females

Abstract

Stress urinary incontinence (SUI) is a condition in which the weakness of the pelvic floor muscles causes unintentional loss of urine. For patients who are unable to achieve symptomatic improvement from lifestyle modification and pharmacotherapy, surgical placement of the pelvic slings or the use of urethral bulking agents has been shown to provide tremendous symptomatic improvement. Learning to recognize the pelvic slings and to identify their complications on imaging is invaluable; however, this is challenging because of the change in the local anatomy after surgical placement of the sling. In this paper, we present CT and MR imaging to demonstrate the surgical and non-surgical treatments of female SUI and their complications. Through this pictorial essay, our goal is to familiarize radiologists with recognizing the various forms of treatment for SUIs, the relevant pelvic anatomy, and complications that may occur secondary to the surgical placement of the pelvic slings.

Foreign body granuloma development after calcium hydroxylapatite injection for stress urinary incontinence: A literature review and case report

“…Patients and radiologists should be made aware that UBAs can often elusively manifest in future radiographic imaging, as improper diagnoses can lead to unnecessary treatments [ 26 ]. Gaines et al report that only 39% of clinical images associated with urethral injection therapy were correctly interpreted by radiology, with the most popular incorrect diagnoses being bladder calculus, urethral calcifications, diverticulum, hypodense area, unknown nodular density, and mass suspected to be cancerous [ 27 ].…”

Applying translabial ultrasound to detect synthetic slings-You can do it too! A comparison of urology trainees to an attending radiologist

“…Synthetic slings are echogenic on ultrasound imaging; therefore ultrasound is a modality uniquely suited for characterizing and locating these slings . In contrast, while sling anchors are visible on CT scan, the sling material itself is not visible . One investigator has reported the ability of MRI to visualize synthetic slings .…”

“…In contrast, while sling anchors are visible on CT scan, the sling material itself is not visible . One investigator has reported the ability of MRI to visualize synthetic slings . However, others have noted that visualization of the periurethral portion of the sling is poor or nonexistent .…”

“…8 One investigator has reported the ability of MRI to visualize synthetic slings. 8 However, others have noted that visualization of the periurethral portion of the sling is poor 9 or nonexistent. 10 Since slings appear hypointense on MRI, postoperative changes that decrease the signal intensity of surrounding tissue can obscure the sling.…”