Ultrasonic Prediction of Stress Urinary Incontinence Development in Surgery for Severe Pelvic Relaxation

Abstract

Forty-six patients with a third-degree cystocele with no complaints of genuine stress urinary incontinence underwent complete urodynamic evaluation including ultrasonic evaluation before and 3 months postoperatively. Ultrasound examination was able to predict in 46 patients those requiring urethropexy surgery for support of their bladder base (n = 22). The 24 patients with good bladder base support by ultrasound did not develop genuine stress urinary incontinence. The use of ultrasound in women with third-degree cystocele appears to predict which patients will require urethropexy surgery in addition to their cystocele repair.

Ultrasonography in stress urinary incontinence

“…Richmond et al [52] found the UVJ to be lower and more mobile in patients with SUI, although in the control group the mobility was different at rest and during stress (mean 1 cm, P<0.001). Contrary to the studies of Bergman et al [47][48][49][50], who took 1 cm of mobility as the critical value for continence, the control patients in this study had a mean mobility of 1 cm.…”

“…Bergman et al [48] proposed that the use of ultrasonography in women with third-degree cystocele appears to predict which patients will require urethropexy surgery in addition to their cystocele repair. They suggested that if UVJ mobility is less than 1 cm on straining, there should be no attempt to tamper with the urethra or UVJ at the time of surgery.…”

“…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.…”

Factors affecting urethrocystographic parameters in urinary continent women

“…In women with severe genital prolapse, ultrasonography can be used to predict which patients will require urethropexy surgery in addition to reconstructive surgery. 20 In some conditions, the use of sonographic evaluation might be a viable option if urodynamic equipment is unavailable. The application of introital sonography with simultaneous urodynamic evaluation may provide more information with regard t o the complex and complicated mechanisms involved in the lower urinary tract.21…”

Long-Term Results of Burch Colposuspension

“…The criterion for BN mobility during stress was taken as 10 mm by ultrasonographical evaluation [17]. In the present study, the BN was significantly higher away from the inferior border of the symphisis pubis and less mobile in the postoperative period than in the preoperative period (table 3).…”