Differences in urodynamic study, perineal sonography and treatment outcome according to urethrovesical junction hypermobility in stress urinary incontinence

Abstract

To evaluate the differences in urodynamic study (UDS) and the perineal ultrasonography parameters between stress urinary incontinence (SUI) patients with or without urethrovesical junction (UVJ) hypermobility. Treatment outcomes following a retropubic urethropexy were also compared. The records of 164 SUI patients (<or=stage II), treated with retropubic urethropexy at our department between January 2001 and February 2004 were reviewed. The patients were categorized into a hypermobility group when the measured Q-tip angle was >or=30, and a non-hypermobility group when <30. All patients underwent UDS and perineal ultrasonography (US) preoperatively. A Burch urethropexy was performed regardless of the Q-tip result. All patients were reevaluated at 1 month and 3 months, postoperatively, and every 3 months thereafter. Ninety-eight patients (60%) had an accompanying UVJ hypermobility and 66 (40%) did not. No significant differences regarding age, parity, body mass index (BMI), menopausal status, hormone replacement status, history of previous gynecologic surgery, or other medico-surgical illness were noted. UDS parameters demonstrated a significant difference between the groups, but were in the normal range. The significant difference noted in the perineal US was the bladder neck descent (BND). Following retropubic urethropexy, the success rates after 1 year were 94% and 91% for the hypermobility group and the non-hypermobility group, respectively, showing no statistical significance. The success rates of Burch urethropexy in the two groups were similar. This result suggests that either the Q-tip is an inaccurate method of evaluating UVJ hypermobility or the presence of UVJ hypermobility does not negatively affect the treatment outcome of a Burch urethropexy.