Open AccessDynamic MRI confirms support of the mid‐urethra by TVT and TVT‐O surgery for stress incontinence
Author(s) -
RINNE KIRSI,
KAINULAINEN SAKARI,
AUKEE SINIKKA,
HEIN SEPPO,
NILSSON CARL G.
Publication year - 2011
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/j.1600-0412.2011.01122.x
Subject(s) - medicine , sling (weapon) , urinary incontinence , urethra , urology , magnetic resonance imaging , pelvic floor , stress incontinence , surgery , radiology
Objective. To study changes in mid‐urethral function with dynamic MRI in stress urinary incontinent women undergoing either tension‐free vaginal tape (TVT) or TVT‐obturator sling operations. Design. Prospective clinical study. Setting. University hospital. Sample. Forty‐two parous women with stress urinary incontinence recruited to dynamic magnetic resonance imaging before and after mid‐urethral sling surgery. Control group of 16 healthy women. Methods. Dynamic magnetic resonance imaging at rest, during pelvic floor muscle contraction, coughing and voiding with a bladder volume of 200–300ml. X‐ and Y‐ coordinates were used to determine the location of the mid‐urethra during these activities. Main Outcome Measures. Changes in mid‐urethral position after TVT and TVT‐obturator operations during the different activities. Results. Postoperatively the women could elevate their mid‐urethra by pelvic floor muscle contraction significantly higher than before the operation ( p <0.05). Despite a different support angle between the TVT and the TVT‐O mid‐urethral slings, we could not see any differences in the movement patterns. Conclusion. Mid‐urethral slings support the mid‐urethra and restrict downward movement during different activities. Movement patterns are similar after TVT and TVT‐O operations.