Effect of tension-free vaginal tape position on the resolution of irritative bladder symptoms in women with mixed incontinence

Duckett, Jonathan; Aggarwal, Ieera Madan; Patil, A.; Vella, Mark

doi:10.1007/s00192-007-0409-6

Cited by 8 publications

(4 citation statements)

References 19 publications

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“…A lack of correlation between the tape position and the clinical outcomes has been previously reported 6 20 23 and was confirmed in the present study, suggesting that factors other than tape position could influence the results of the insertion of the MUS. 23 24 Although some sonographic measurements reached statistical significance in the group comparisons, the differences are on the order of millimeters, and are not clinically significant.…”

Section: Discussionsupporting

confidence: 78%

“…These results are also similar to those obtained by others researchers. [19][20][21] We observed that 66.7% of the patients with the tape located in the distal urethra had a BMI > 30 kg/m 2 (obese status), while among those with the tape located in the mid-urethra, only 34% were obese. Thus, obesity appears to be a factor favoring a more distal position of the sling.…”

Section: Discussionmentioning

confidence: 85%

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Pelvic Floor 3D Ultrasound of Women with a TVT, TVT-O, or TVT-S for Stress Urinary Incontinence at the Three-year Follow-up

Rodrigues

Bianchi-Ferraro

Zucchi

et al. 2017

Rev Bras Ginecol Obstet

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Objective Using three-dimensional ultrasound (3D-US), we aimed to compare the tape position and the angle formed by the sling arms in different techniques of mid-urethral sling insertion for the surgical treatment of stress urinary incontinence, three years after surgery. In addition, we examined the correlations between the US findings and the clinical late postoperative results. Methods A prospective cross-sectional cohort study of 170 patients who underwent a sling procedure between May 2009 and December 2011 was performed. The final sample, with US images of sufficient quality, included 26 retropubic slings (tension-free vaginal tape, TVT), 42 transobturator slings (tension-free vaginal tape-obturator, TVT-O), and 37 single-incision slings (tension-free vaginal tape-Secur, TVT-S). The images (at rest, during the Valsalva maneuver, and during pelvic floor contraction) were analyzed offline by 2 different observers blinded against the surgical and urinary continence status. Group comparisons were performed using the Student t-test, the chi-squared and the Kruskal-Wallis tests, and analyses of variance with Tukey multiple comparisons. Results Differences among the groups were found in the mean angle of the tape arms (TVT = 119.94°, TVT-O = 141.93°, TVT-S = 121.06°; p < 0.001) and in the distance between the bladder neck and the tape at rest (TVT = 1.65 cm, TVT-O = 1.93 cm, TVT-S = 1.95 cm; p = 0.010). The global objective cure rate was of 87.8% (TVT = 88.5%, TVT-O = 90.5%, TVT-S = 83.8%; p = 0.701). The overall subjective cure rate was of 83.8% (TVT = 88.5%, TVT-O = 88.5% and TVT-S = 78.4%; p = 0.514). The slings were located in the mid-urethra in 85.7% of the patients (TVT = 100%, TVT-O = 73.8%, TVT-S = 89.2%; p = 0.001), with a more distal location associated with obesity (distal: 66.7% obese; mid-urethra: 34% obese; p = 0.003). Urgency-related symptoms were observed in 23.8% of the patients (TVT = 30.8%, TVT-O = 21.4%, TVT-S = 21.6%; p = 0.630). Conclusions The angle formed by the arms of the sling tape was more obtuse for the transobturator slings compared with the angles for the retropubic or single-incision slings. Retropubic slings were more frequently located in the mid-urethra compared with the other slings, regardless of obesity. However, the analyzed sonographic measures did not correlate with the urinary symptoms three years after the surgery.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 85%

Pelvic Floor 3D Ultrasound of Women with a TVT, TVT-O, or TVT-S for Stress Urinary Incontinence at the Three-year Follow-up

Rodrigues

Bianchi-Ferraro

Zucchi

et al. 2017

Rev Bras Ginecol Obstet

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“…Predictors of mid-term outcome after suburethral sling procedures are still a matter of scientific debate [17–20]. The mid-term data we presented here suggest that sonographic evaluation of tape functionality at 6 months provides clues to mid-term outcome and complications.…”

Section: Discussionmentioning

confidence: 78%

Tape functionality: position, change in shape, and outcome after TVT procedure—mid-term results

Kociszewski¹,

Rautenberg

Kolben³

et al. 2010

Int Urogynecol J

101

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Introduction and hypothesisThis study evaluates the relevance of the tape position and change in shape (tape functionality) under in vivo conditions for mid-term outcome.MethodsChanges in the sonographic tension-free vaginal tape (TVT) position relative to the percentage urethral length and the tape–urethra distance were determined after 6 and 48 months in 41 women with stress urinary incontinence.ResultsAt 48 months, 76% (31/41) of women were cured, 17% (7/41) were improved, and 7% (3/41) were failures. Disturbed bladder voiding was present in 12% (5/41), de novo urge incontinence in 7% (3/41). The median TVT position was at 63% of urethral length. Median tape–urethra distance was 2.7 mm, ranging from 2.9 mm in continent patients without complications to 1.1 mm in those with obstructive complications. Patients with postoperative urine loss had a median distance of 3.9 mm. The tape was stretched at rest and C-shaped during straining in 15 of 41 women (37%) at 48 months (all continent). Patients with this tape functionality at 6 months were also cured at 48 months in 86% of cases (19/22), and only 14% (3/22) showed recurrent incontinence.ConclusionsMid-term data suggest an optimal outcome if the tape is positioned at least 2 mm from the urethra at the junction of the middle and distal thirds. Patients with optimal tape functionality at 6 months are likely to show mid-term therapeutic success.

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“…In clinical settings, the UFR is useful for assessing voiding functions and predicting voiding difficulties following a continence operation, such as tension-free vaginal tapes (12,25). In our study, the activation of 5-HT 1A receptors by 8-OH-DPAT significantly increased the UFR during the initial segment of the flow duration in female rats; this is clinically relevant because serotonergic drugs may alter the pattern of urinary flow (34, 35).…”

Section: Perspectives and Significancementioning

confidence: 50%

Does pharmacological activation of 5-HT_1A receptors improve urine flow rate in female rats?

Chen

Hsieh

Fan

et al. 2016

American Journal of Physiology-Renal Physiology

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Chen SC, Hsieh TH, Fan WJ, Lai CH, Peng CW. Does pharmacological activation of 5-HT1A receptors improve urine flow rate in female rats? Am J Physiol Renal Physiol 311: F166 -F175, 2016. First published May 4, 2016 doi:10.1152/ajprenal.00469.2015.-The role of 5-HT1A receptors in regulating voiding functions remains unclear, particularly regarding the urine flow rate (UFR) during voiding. This study examined the effects of 5-HT1A receptors on regulating urethral functions in female rats and investigated underlying modulatory mechanisms. Intravesical pressure (IVP), external urethral sphincterelectromyography (EUS-EMG), and UFR were simultaneously recorded during continuous transvesical infusion to examine the effects of a 5-HT1A receptor agonist (8-OH-DPAT) and antagonist (WAY-100635) on bladder and urethral functions. In addition, this study evaluated the independent roles of urethral striated and smooth muscles in the UFR in rats after a neuromuscular blockade (NMB) treatment and bilateral hypogastric nerve transection. Our results revealed that 8-OH-DPAT significantly increased the maximal UFR but reduced the mean UFR. This discrepancy may be because 8-OH-DPAT markedly increased the maximal UFR during the initial segment of the flow duration and subsequently induced an approximately zero level of long oscillatory waves during the remaining flow duration. Thus the mean UFR was reduced because of the prolonged approximately zero level of the UFR. However, paralyzing the EUS with an NMB agent, 8-OH-DPAT, significantly increased the maximal and mean UFRs because the prolonged zero level of the oscillatory UFR did not continue. These results support the hypothesis that the increased UFR in female rats during voiding is due to the induction of urethral smooth muscle relaxation by 8-OH-DPAT. This paper provides a detailed understanding of the role of 5-HT 1A receptors in controlling the UFR in female rats. intravesical pressure; EUS-EMG; 8-OH-DPAT; WAY-100635; neuromuscular blockade THE PRIMARY FUNCTIONS OF THE lower urinary tract (LUT) are storage and periodic urine elimination. These functions require reciprocal coordination between the urinary bladder and urethra outlets, including the bladder neck, urethra, and external urethral sphincter (EUS). The urethra consists of smooth and striated muscle layers that are regulated by the following three peripheral nerve sets: sacral parasympathetic (pelvic nerves) and thoracolumbar sympathetic nerves (hypogastric nerves) that innervate urethral smooth muscles, and sacral somatic nerves (pudendal nerves) that innervate urethral striated muscles including the EUS and pelvic floor muscles.Receptors for serotonin [5-hydroxytryptamine (5-HT)] comprise 14 structurally different 5-HT receptors in mammalian species, including 7 subfamilies (5-HT 1 -5-HT 7 ) (28). Pharmacological studies in animals have indicated that the three sets of LUT nerve terminals contain numerous 5-HT receptor subfamilies. Specifically, 5-HT 1A receptors are vital to LUT functions (32). The effects of 5-HT...

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Effect of tension-free vaginal tape position on the resolution of irritative bladder symptoms in women with mixed incontinence

Cited by 8 publications

References 19 publications

Pelvic Floor 3D Ultrasound of Women with a TVT, TVT-O, or TVT-S for Stress Urinary Incontinence at the Three-year Follow-up

Pelvic Floor 3D Ultrasound of Women with a TVT, TVT-O, or TVT-S for Stress Urinary Incontinence at the Three-year Follow-up

Tape functionality: position, change in shape, and outcome after TVT procedure—mid-term results

Does pharmacological activation of 5-HT_1A receptors improve urine flow rate in female rats?

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