EP36.06: Transperineal ultrasound assessment of anatomical changes before and after surgery with tension‐free vaginal tape for stress urinary incontinence

Abstract

To study changes in symptoms and bladder neck in women undergoing tension-free vaginal tape (TVT) surgery for stress urinary incontinence (SUI). Secondarily, to study any association between postoperative anatomy, TVT placement and symptoms. Prospective observational study of 65 women with SUI assessed on the day of TVT surgery and 6 months later. They answered yes/no to questions about SUI and urge urinary incontinence (UUI). Transperineal ultrasound was used to assess urethral funneling at Valsalva and abnormal bladder neck descent (BND) defined as > 25 mm descent from rest to Valsalva. The distance from the TVT to the bladder neck at rest and to the symphysis at Valsalva were measured. Any differences between pre- and postoperative symptoms and anatomy and any association between postoperative anatomy and SUI were tested with Fisher's exact, X2 or t-test. Mean (SD) age was 50 (9) years and BMI 26.3 (4.5) kg/m2. Table 1 compares symptoms and anatomy before and after surgery. 52/60 (87%) women were cured for SUI. Women with persistent SUI had similar postoperative anatomy and TVT placement as cured women: BND > 25 mm 0/6 (0%) vs. 4/51(8%), funneling 0/6 (0%) vs. 16/51 (31%), TVT distance from bladder neck 2.2 (0.7) cm vs. 2.1 (0.5) cm, and from symphysis 1.6 (0.3) cm vs. 1.5 (0.3) cm; all p > 0.05. TVT surgery had a high cure rate for SUI. Women with mixed incontinence had less UUI after surgery and funneling was significantly reduced. No association between persistent SUI, BND, funneling or TVT placement was found. Persistent SUI could be associated with other factors, such as hormonal status and intrinsic urethral pressure. EP36.06: Table 1. 65/65 100% 8/60 13% 38/65 61% 11/60 18% 13/65 20% 4/57 7% 25/65 39% 16/57 28% Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.