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Tape functionality: sonographic tape characteristics and outcome after TVT incontinence surgery


Kociszewski, J; Rautenberg, O; Perucchini, D; Eberhard, J; Geissbühler, V; Hilgers, R; Viereck, V (2008). Tape functionality: sonographic tape characteristics and outcome after TVT incontinence surgery. Neurourology and Urodynamics, 27(6):485-490.

Abstract

AIM: To investigate tension-free vaginal tape (TVT) position and shape using ultrasound (US) and correlate the findings to outcome.
MATERIAL AND METHODS: The results of TVT surgery were investigated in 72 women with urodynamic stress urinary incontinence. The main outcome parameters were US tape position in relation to the urethra and dynamic changes in TVT shape at rest and during straining. RESULTS: Sixty-two patients (86%) were continent, 6 (8%) significantly improved, and the operation failed in four cases (6%). The median tape position was at 66% of the urethral length measured by US. The median tape-urethra-lumen distance was 3.8 mm at rest. Tape placement in the upper or lower quarter of the urethra was associated with a higher failure rate. Tapes positioned less than 3 mm from the urethra significantly increased postoperative complications (P < 0.0001). The tape was flat at rest and curved during straining in 44 (61%) patients; 98% (43/44) of these women were continent after surgery. An unchanged tape shape was associated with a poorer outcome (P = 0.00038). Patients with a flat tape at rest and during straining failed in 25% and patients with a permanent curved shape in 10%.
CONCLUSIONS: TVT position relative to the patient's urethra seems to play a role in treatment outcome. Outcome was best in patients with dynamic change in tape shape during straining and location of the tape at the junction between the lower and middle urethra and at least 3 mm from the urethral lumen.

AIM: To investigate tension-free vaginal tape (TVT) position and shape using ultrasound (US) and correlate the findings to outcome.
MATERIAL AND METHODS: The results of TVT surgery were investigated in 72 women with urodynamic stress urinary incontinence. The main outcome parameters were US tape position in relation to the urethra and dynamic changes in TVT shape at rest and during straining. RESULTS: Sixty-two patients (86%) were continent, 6 (8%) significantly improved, and the operation failed in four cases (6%). The median tape position was at 66% of the urethral length measured by US. The median tape-urethra-lumen distance was 3.8 mm at rest. Tape placement in the upper or lower quarter of the urethra was associated with a higher failure rate. Tapes positioned less than 3 mm from the urethra significantly increased postoperative complications (P < 0.0001). The tape was flat at rest and curved during straining in 44 (61%) patients; 98% (43/44) of these women were continent after surgery. An unchanged tape shape was associated with a poorer outcome (P = 0.00038). Patients with a flat tape at rest and during straining failed in 25% and patients with a permanent curved shape in 10%.
CONCLUSIONS: TVT position relative to the patient's urethra seems to play a role in treatment outcome. Outcome was best in patients with dynamic change in tape shape during straining and location of the tape at the junction between the lower and middle urethra and at least 3 mm from the urethral lumen.

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33 citations in Web of Science®
38 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Gynecology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2008
Deposited On:13 Jan 2009 08:44
Last Modified:05 Apr 2016 12:49
Publisher:Wiley-Blackwell
ISSN:0733-2467
Publisher DOI:10.1002/nau.20556
PubMed ID:18288705
Permanent URL: http://doi.org/10.5167/uzh-10094

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