1347 ULTRASOUND IMAGING OF TRANSOBTURATOR MALE AND FEMALE SLINGS – IS THERE A COMMON MECHANISM OF ACTION?

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Incontinence—Evaluation & Therapy1 Apr 20111347 ULTRASOUND IMAGING OF TRANSOBTURATOR MALE AND FEMALE SLINGS – IS THERE A COMMON MECHANISM OF ACTION? Lewis Chan Lewis ChanLewis Chan Sydney, Australia More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1168AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There is increasing use of transobturator slings in the treatment of male and female stress urinary incontinence. The aim of this study was to evaluate the technique and feasibility of ultrasound imaging in patients with synthetic transobturator slings and assess their potential mechanism of action. METHODS Transperineal ultrasound was performed on 12 male patients who underwent AdVance transobturator male sling,10 females who were continent following Monarc transobturator sling and 3 females who had voiding dysfunction following placement of suburethral sling. Ultrasound examinations were conducted using a SonoSite M-Turbo ultrasound machine and C5-2 MHz transducer. Patients were imaged at bladder volumes of over 150mls in supine and standing positions, at rest and on Valsalva. Imaging findings including bladder neck position, urethral mobility and position of the sling relative to the urethra on dynamic imaging were recorded. RESULTS All 25 slings were well visualized on transperineal ultrasound. The Monarc slings were located at the level of the mid-urethra while AdVance slings were located at or above the inferior border of the pubic symphysis. Urethral mobility was demonstrated with Valsalva in both male and female patients and was more pronounced in females. During Valsalva, there was dynamic compression of the urethra from the Monarc sling in females who were continent but angulation/kinking of the urethra was observed only in patients who had voiding dysfunction due to sling obstruction. This was more evident in the standing position. In males with the AdVance sling there was less urethral mobility compared to females but dynamic compression of the urethra was also demonstrated with Valsalva and coughing. CONCLUSIONS Transperineal ultrasound is a good modality of imaging for demonstration of synthetic suburethral slings. Dynamic compression of the urethra by transobturator sling was demonstrated during Valsalva in patients with AdVance and Monarc slings suggesting that these slings have a similar mechanism of action in restoring continence in male and female patients with stress incontinence. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e538 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lewis Chan Sydney, Australia More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...