Usefulness of Perineal Ultrasonography after Tension-Free Vaginal Tape Procedure for Stress Urinary Incontinence

Yoon, Seong Kuk

Abstract

PURPOSE: To evaluate the usefulness of perineal ultrasonography after a tension-free vaginal tape (TVT) procedure in women with stress urinary incontinence.
MATERIALS AND METHODS
Thirty-four patients with stress urinary incontinence who underwent the TVT procedure were included in this study. We compared the perineal ultrasonography findings before and after the procedure. The mean age was 49 years (range: 32-75 years) and the mean follow-up time was 9.5 days (range: 5-19 days). We obtained the entire sagittal image of the bladder neck, urethra, urethrovesical junction and symphysis pubis. The posterior urethrovesical angle (PUVA) and descent of the bladder neck at rest and during stress, and the diameter of proximal urethra at rest were all evaluated. We compared these ultrasonographic changes before and after the procedure.
RESULTS
Before the TVT procedure, the PUVA was 134.7+/-5.9degree at rest and 146.8+/-8.5degree during stress, and the difference between PUVA at rest and during stress was 12.2+/-7.3degree. After the TVT procedure, the PUVA significantly decreased to 125.6+/-7.5degree at rest and 132.5+/-8.3degree during stress, and the difference also significantly decreased to 7.0+/-5.0degree (p<0.01). Before the procedure, the descent of the bladder neck was 17+/-7.0 mm, while the descent significantly decreased to 7.7+/-4.1 mm after the procedure (p<0.01). Before the procedure, the diameter of the proximal urethra was 5.6+/-1.4 mm at rest, but the diameter was 5.5+/-1.1 mm, without significant change, after the procedure.
CONCLUSION
Follow-up perineal ultrasonography after the TVT procedure may be useful for evaluating changes including the PUVA, descent and appearance of the bladder neck.