Ultrasound Assessment of Tension-Free Vaginal Tape (TVT)

Flock, F.; Kohorst, Frauke; Reich, Andreas

doi:10.1055/s-0029-1245798

Cited by 19 publications

(21 citation statements)

References 15 publications

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“…Our findings show that when inserting a TOT, beginning the incision at 1/2 the urethral length was more likely to result in a successful outcome than at 1/3 of the urethral length—similar to the standard technique for classical retropubic TVT . One important conclusion of this study, which is consistent with earlier studies, is that patient characteristics (i.e., urethral mobility) ought to be assessed and appropriately matched with the particular functionality of the tapes …”

Section: Discussionsupporting

confidence: 86%

“…However, Ulmsten's technique was originally developed using technology available over two decades ago that involved radiomorphologic and urodynamic studies. Recent studies utilizing advanced, dynamic medical technology (i.e., 3D/4D ultrasound) found that variations in anatomical/physiological characteristics of women (i.e., urethral length, height of the vaginal sulci, and mobility of the urethra) influence the success of the SUI outcome and the occurrence of postoperative complications …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Do different vaginal tapes need different suburethral incisions? The one-half rule

Viereck

Kuszka

Rautenberg

et al. 2014

Neurourol. Urodynam.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Do different vaginal tapes need different suburethral incisions? The one-half rule

Viereck

Kuszka

Rautenberg

et al. 2014

Neurourol. Urodynam.

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show abstract

“…A distance of the sling of more than 5 mm from the LSM complex was associated with SUI. Although the importance of the sling location has been disputed in the literature [7, 9, 18–21], mounting evidence suggests that too much tension placed on the sling as well as dystopic sling positioning (i.e., too proximal at the level of the bladder neck), should be avoided whenever possible.…”

Section: Discussionmentioning

confidence: 99%

Midurethral sling incision: indications and outcomes

Viereck

Rautenberg

Kociszewski³

et al. 2012

Int Urogynecol J

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Introduction and hypothesisControversy continues over the effectiveness of sling incision, which is the most common operative approach to treating complications following suburethral sling insertion. This retrospective analysis assessed the indications for sling incision and patient outcomes regarding resolution of complications and stress urinary incontinence.MethodsA review was conducted of the medical records of women who underwent sling incision between 2003 and 2010. Data such as surgical indications, ultrasound findings and medical outcomes were extracted from 198 records, and descriptive and inferential statistical methods of analysis were used.ResultsIn the 198 patients eligible for study inclusion, the primary reasons for sling incision were overactive bladder (68 %), voiding dysfunction (61 %), and recurrent urinary tract infections (53 %). Additional complications included dyspareunia (18 %), chronic pelvic pain (17 %), and sling exposure (15 %). Sling incision led to immediate postoperative cure of voiding dysfunction in 97 % of patients. Cure rates for overactive bladder and dyspareunia were 60 % and 94 % respectively. Chronic pelvic pain was resolved in 82 % of cases and all cases of sling exposure were cured. Eighty-five (61 %) of the 140 patients who were continent before sling incision developed recurrent stress urinary incontinence (SUI) postoperatively.ConclusionsThese findings indicate that sling incision can be highly successful in improving voiding dysfunction and dyspareunia, and moderately successful in curing overactive bladder and chronic pain. However, SUI may recur in more than 60 % of the patients undergoing sling incision. Consequently, patients being considered for a sling incision procedure should be informed about this possible complication.

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“…In this regard it is helpful to evaluate the tape by ultrasound. We arranged an own study to that question with introital ultrasound [32]. Regarding the distance between tape and urethra there were significant differences in patients with residual volume compared with women without residual volume.…”

Section: Discussionmentioning

confidence: 99%

Voiding Dysfunction after the Tension-Free Vaginal Tape Procedure

Reich

Kohorst²,

Flock³

2011

Gynecol Obstet Invest

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Aim: To assess the incidence of voiding dysfunction in women undergoing a tension-free vaginal tape (TVT) procedure and report our experience with nonsurgical and surgical management. Methods: Pre- and postoperative introital ultrasonographic measurement of the residual volume was performed in a prospective observational study. Patients’ perception of micturition and continence status was assessed by questionnaire. Results: Of 478 women, 4 (0.8%) suffered from micturition disturbance within the first 2 weeks. In the mean of 3 months after surgery, 7.1% of the patients had residual volume between 50 and 100 ml, and 2.6% had residual volume >100 ml. 243 women were investigated after 39 months (range 12–74). The rate of residual volume exceeding 50 ml decreased to 6.5% and was approximated to the preoperative period. Conclusion: Incomplete bladder emptying is a possible problem after TVT. In our cohort, 93% of the women had no voiding disturbances or marginally affected voiding after 12–74 months.

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Ultrasound Assessment of Tension-Free Vaginal Tape (TVT)

Abstract: TVT may be regularly investigated using ultrasound. In combination with the clinical outcome, it represents an important method of evaluating the tape and assists in the planning of a future therapeutic course of action in cases of postoperative problems.

Cited by 19 publications

References 15 publications

Do different vaginal tapes need different suburethral incisions? The one-half rule

Do different vaginal tapes need different suburethral incisions? The one-half rule

Midurethral sling incision: indications and outcomes

Voiding Dysfunction after the Tension-Free Vaginal Tape Procedure

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