Document Detail


Positioning of a suburethral sling at the bladder neck is associated with a higher recurrence rate of stress urinary incontinence.
MedLine Citation:
PMID:  23341378     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objectives The purpose of this study was to investigate the relationship between the suburethral sling position and the outcome of anti-incontinence surgery. Methods From 1998 to 2010, the medical records of 153 consecutive women with stress urinary incontinence undergoing the pubovaginal sling procedure were retrospectively reviewed. All patients received preoperative and postoperative transrectal sonography of the bladder and urethra, and the suburethral sling position was used to compare the postoperative continence status and lower urinary tract symptoms. Results The mean patient age ± SD was 60.7 ± 10.6 years (range, 34-85 years), and the mean follow-up was 66.3 ± 42.1 months (range, 6-149 months). The slings were located at the bladder neck in 18 patients (11.8%), proximal urethra in 81 (52.9%), middle urethra in 45 (29.4%), and distal urethra in 9 (5.9%). The overall rate of recurrent stress urinary incontinence was 24.2% (37 patients). Among the 153 patients, there was a significantly higher stress urinary incontinence recurrence rate in the bladder neck group (bladder neck, 50.0%; proximal urethra, 18.5%; middle urethra, 22.2%; and distal urethra, 33.3%; P = .037). De novo urge and voiding symptoms occurred in 19.0% and 20.3% of overall patients, respectively. There was no significant difference in either de novo urge or voiding symptoms among groups. Conclusions Positioning of the suburethral sling at the bladder neck appears to be associated with a higher stress urinary incontinence recurrence rate. Patients with slings located at the proximal and middle urethra had the best postsurgical continence rates. The suburethral sling position had no direct association with de novo urge or voiding symptoms.
Authors:
Yuan-Hong Jiang; Chung-Cheng Wang; Fei-Chi Chuang; Qian-Sheng Ke; Hann-Chorng Kuo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine     Volume:  32     ISSN:  1550-9613     ISO Abbreviation:  J Ultrasound Med     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211547     Medline TA:  J Ultrasound Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  239-45     Citation Subset:  IM    
Affiliation:
Department of Urology, Buddhist Tzu Chi General Hospital 707, Section 3, Chung Yang Rd, Hualien, Taiwan. hck@tzuchi.com.tw.
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