Perineal ultrasonography in postoperative assessment of two different surgical procedures for stress urinary incontinence

Abstract

Thirty-eight incontinent and 57 continent patients who had undergone MMK urethropexy and anterior colporrhaphy procedures were examined by perineal ultrasonography. Bladder neck hypermobility was described with ventrodorsal and cephalocaudal directional parameters. In the incontinent patients both cephalocaudal and ventrodorsal mobilities were found to be significantly greater compared to the continent group, the latter ultrasonographic parameter being relatively more significant (P < 0.01 and P < 0.001, respectively). In surgically cured patients who underwent the MMK procedure both ventrodorsal and cephalocaudal mobility had been significantly limited in contrast to their incontinent counterparts; but these differences had been detected only in ventrodorsal mobility by the anterior colporrhaphy procedure.

Ultrasonography in stress urinary incontinence

“…The mobility of the UVJ during stress is evaluated unidirectionally or as two components in the cephalocaudal and ventrodorsal directions. UVJ mobility is used most commonly as a criterion of SUI by most authors [19,24,25,[27][28][29][30][31]37,39,40,52] without taking any standard mobility measurement. A commonly accepted standard measurement of UVJ mobility is equal to or more than 1 cm.…”

“…Demirci et al [27] took a different approach using perineal ultrasonography compared to previous authors. Those that use perineal ultrasonography measure the movement of the UVJ in only one direction [19,23,25,26].…”

“…During ultrasonographic examination the bladder is filled with fluid to least 200 ml [37,40], 200-300 ml [51,54], 400 ml [39], 250 ml [24,53], 300 ml [23,27,28,30,34], 100-400 [251 or fully [10,21,38,39,41,[47][48][49][50]. In one study [45] the bladder was filled with 250 ml and 500 ml fluid and vaginal ultrasonography was repeated.…”

Die Perinealsonographie zur Diagnostik der männlichen Belastungsinkontinenz

“…Sowohl beim Miktionszysturethrogramm als auch beim TRUS ist die Möglichkeit der Beurteilung der urethralen Mobilität eingeschränkt. Darüber hinaus kann die im Rektum gelegene Sonde die Beweglichkeit des Blasenhalses beeinträchtigen und die Fähig-keit zum Pressen herabsetzen [12], sodass die Untersuchungsergebnisse möglicher-weise an Aussagekraft verlieren. Des Weiteren ist die Untersuchung für den Patienten unangenehm und bisweilen schmerzhaft.…”

A new ultrasonographic method for evaluation of the results of anti‐incontinence operations

“…Ultrasonography has been used for postoperative evaluation of patients to document the reasons of failed operations (4–7). These evaluations suggested that patients with successful operations had beneficial stabilization of the bladder necks by surgical repair, while those with persistent or recurrent incontinence were associated with reacquisition of the bladder neck hypermobility (4–9). Although, several different measurement methods have been proposed to objectively document the position or the mobility of the bladder neck, the effectiveness of these methods was controversial (4–13).…”