Demographic features of female urethra length

Abstract

Differences in urethral length in the female population were demonstrated. Thirty percent of patients have atypical urethras that may be a risk factor for sling surgery failure. We therefore postulate introduction of urethral measurement before the procedure.

Agreement between simple catheter method and 3D transperineal ultrasound for assessing urethral length measurement before stress urinary incontinence treatment

“…The mean urethral length assessed by a foley catheter was found to resemble that assessed using 3D transperineal ultrasound (3.02 ± 0.41 cm and 3.03 ± 0.34 cm, respectively), suggesting agreement between the two methods. This data is also in line with previous studies reporting a urethral length range of 2‐4 cm measured with introital ultrasound in women with SUI . Also supporting the agreement between the two methods, the ICC obtained suggests excellent accordance (ICC = 0.90) with the standard proposed by Portney et al Moreover, the Bland‐Altman analysis revealed a mean difference close to 0 (−0.01 ± 0.23 cm), showing little to no bias between the two methods.…”

“…Optimal placement of the material plays an important role in the bulking‐agent efficacy for SUI in women . Given the wide variation in urethral anatomy, mid‐urethral sling efficacy may also be enhanced by optimizing tape location . Physicians often use a foley catheter to evaluate the urethral length and, hence, determine the most suitable injection site or identify the mid‐urethral zone.…”

“…A large cohort study by Pomian et al has recently described a wide variation in urethral length including atypical urethra which reinforces the relevance of assessing the urethral length prior to injection in order to determine the adequate injection site, such as the mid‐urethral zone for instance . It should also be underlined that a precise identification of the mid‐urethral zone may also be relevant for optimizing mid‐urethral sling placement . Three‐dimensional (3D) ultrasound imaging has been reported to be useful and reliable in assessing urethral morphology and identifying the injection site .…”

“…16 It should also be underlined that a precise identification of the mid-urethral zone may also be relevant for optimizing mid-urethral sling placement. 16 Three-dimensional (3D) ultrasound imaging has been reported to be useful and reliable in assessing urethral morphology and identifying the injection site. 9 But because such technology may not be readily available, physicians could rely on a foley catheter to assess the urethral length.…”

Proximal location of explanted midurethral slings is associated with urinary storage symptoms

“…Operative reports were reviewed for surgeon description of mesh location at the time of explant. When the surgeon described sling location only in reference to distance from the urethral meatus, the distal urethra was defined as within 1 cm of the meatus, the midurethra was defined as 1 to 3 cm from the meatus, and the proximal urethra/bladder neck (PU/BN) was defined as more than 3 cm from the meatus based on average urethral length of 3 + 0.4 cm . When there was no explicit description of sling location in the operative report sling location was inferred to be midurethral.…”