Role of intrinsic sphincter deficiency with and without urethral hypomobility on the outcome of tape insertion

Abstract

The reduced cure rate for ISD patients was due to the subgroup with a hypomobile urethra. A prospective study is needed to confirm that slightly shorter tape-urethra distances and a relative tape position more toward the mid-urethra will lead to better outcomes for this patient group.

The analysis of repeatability and reproducibility of bladder neck mobility measurements obtained during pelvic floor sonography performed introitally with 2D transvaginal probe

“…Several sonographic approaches have been used for the study of urogynecologic symptoms: suprapubic, translabial, transvaginal, transperineal, introital, 2D, 3D and 4D [1,13,19]. There is no consensus on optimal approach to be used for different situations.…”

“…Also, no comparison was performed between different approaches [1]. PFS-TV is one of the methods recently applied to urogynecology [17][18][19]. Recent clinical studies on PFS-TV have confirmed the adverse effect of the CI point hypomobility on SUI cure rate after implantation of suburethral tape [17][18][19].…”

“…PFS-TV is one of the methods recently applied to urogynecology [17][18][19]. Recent clinical studies on PFS-TV have confirmed the adverse effect of the CI point hypomobility on SUI cure rate after implantation of suburethral tape [17][18][19]. The results of these studies have led to definitions of hypomobile, normomobile and hypermobile urethra based on the value of the vector parameter [19].…”

“…As opposed to previous studies [17][18][19], our location of the internal urethral orifice is defined with two points; point CI is the more anterior edge of the internal urethral orifice, visualized in the ultrasound image as closer to the pubic symphysis. Point CII is the more posterior edge of the urethral internal orifice visualized more peripherally.…”

“…Recent studies show that pelvic floor sonography performed with 2D transvaginal probe (PFS-TV) may detect patients with reduced bladder neck mobility while such condition had a negative impact on the results of SUI surgery with suburethral tape implantation, even when the surgery was individually planned. In turn, patients with normomobile and hypermobile urethra detected with PFS--TV had a much higher chance of successful SUI correction, even if the tape was suboptimally placed [17][18][19]. However, the repeatability and reproducibility of the analysis of bladder neck mobility with PFS-TV has not been established yet.…”