Open AccessSonographic sling position and cure rate 10-years after TVT- O procedure
Author(s) -
Ayman Tamma,
Vesna BjelicRadisic,
S Hölbfer,
Gerda Trutnovsky,
Karl Tamussino,
T Aigmüller,
Ulrich Dirnagl
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0209668
Subject(s) - medicine , sling (weapon) , neck of urinary bladder , sexual function , urinary incontinence , overactive bladder , surgery , urethra , valsalva maneuver , pubic symphysis , pelvic floor , urinary bladder , pelvis , alternative medicine , pathology , blood pressure
Aim To examine the position of the TVT-O sling 10 years postoperatively and its association with outcome. Methods A total of 124 patients who received a TVT-O sling at two centers in 2004 and 2007 were invited for follow-up. The position of the sling on perineal ultrasound was described relative to the bladder neck and the lower margin of the pubic symphysis at rest and on Valsalva. Objective cure was defined as a negative cough stress test at 300 ml. Subjective cure was evaluated with the Kings´ Health Questionnaire (KHQ), Incontinence Outcome Questionnaire (IOQ), Female Sexual Function Index Questionnaire (FSFI) and the Patient Global Impression of Improvement score (PGII). Results 78 of 124 patients (57%) were available for follow-up 10 years after surgery. I Eleven (14%) had undergone reoperation and were excluded. Tapes were visualized in the remaining 67 (54%) women. The subjective and objective cure rates in this sub-cohort were 67% (45/67) and 77% (52/67), respectively. In these 67 women the mean distances from the bladder neck to the proximal edge of the tape (BNTD) during Valsalva maneuver were significantly higher in cured women compared to the not-cured women (11.2 vs. 9.4mm). The distance between tape and urethra (TUD) was significantly lower in cured vs. not cured patients (2.6 vs. 4.1mm). All women with a TUD of >5mm (n = 5) were incontinent. Tape position was not associated with overactive bladder symptoms. Conclusions Tape position near the bladder neck and large distance to the urethra is associated with incontinence 10 years after TVT-O.