The position of the urethrovesical junction after incontinence surgery: early postoperative changes.
This study prospectively evaluated the position of the urethrovesical junction using the Q-tip angle to assess early postoperative changes for different anti-incontinence surgeries. All procedures resulted in a statistically significant change in resting angle from the intraoperative value. The mean change for the transvaginal tape was 25.74 degrees (27.43 to 3.28); Burch 11.18 degrees (-20.44 to -10.0) and fascia sling 13.9 degrees (26.57 to 15.68). The mean change in Q-tip angle was greater after transvaginal tape placement than after Burch ( p=0.000) and fascial sling ( p=0.022) procedures. These findings show that the resting position of the urethrovesical junction after surgery is different for all procedures. The transvaginal tape results in the greatest change in angle. This may help to negate the so-called 'tension-free' nature of the procedure. Surgeons need to be aware of this, as it may be an etiological factor in cases of late urinary retention and urethral erosion.
McLennan
Mary T
MT
Division of Urogynecology and Reconstructive Pelvic Surgery, Gynecology and Women's Health, St. Louis University Department of Obstetrics, St. Louis, Missouri, USA. mclennam@slucare1.sluh.edu
Melick
Clifford F
CF
Cannon
Sara
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D013536:Suture Techniques; D014521:Urethra / Q000033:anatomy & histology* / Q000473:pathology* / Q000601:surgery; D001743:Urinary Bladder / Q000033:anatomy & histology* / Q000473:pathology* / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D016055:Urinary Retention / Q000209:etiology*; D014621:Vagina / Q000601:surgery