Stress incontinence and low urethral closure pressure. Correlation of preoperative urethral hypermobility with successful suburethral sling procedures.
Forty-eight women with genuine stress incontinence and low urethral closure pressure were treated with a suburethral sling procedure using polytetrafluoroethylene. All patients underwent a preoperative clinical evaluation and multichannel urodynamic testing. The clinical examination included a "Q-tip" test to determine the presence or absence of urethral hypermobility. Urethral hypermobility was defined as a maximal angle change of greater than or equal to 30 degrees from the horizontal, measured during straining or coughing in the lithotomy position. Thirty-four patients underwent repeat multichannel urodynamic testing three months postoperatively to determine the objective surgical success. Ninety-three percent of patients (27/29) with a positive preoperative Q-tip test were cured. Of patients with a negative preoperative Q-tip test, only 20% (1/5) were cured. Preoperative urethral hypermobility was a good prognostic indicator of operative success when a suburethral sling procedure was used to treat genuine stress incontinence and low urethral closure pressure.
Summitt
R L
RL
Department of Obstetrics and Gynecology, University of California, Irvine.
Bent
A E
AE
Ostergard
D R
DR
Harris
T A
TA
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008722:Methods; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011312:Pressure; D019736:Prostheses and Implants; D014521:Urethra / Q000503:physiopathology*; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy
D011138:Polytetrafluoroethylene