Ultrasound imaging of the lower urinary tract after successful tension-free vaginal tape (TVT) procedure.
OBJECTIVE
To evaluate changes in the mobility of the whole urethra, in the proximal urethra (funneling) and in the thickness of the urinary bladder wall, after a successful tension-free vaginal tape (TVT) procedure.


METHODS
This prospective longitudinal study included 52 women with urodynamically confirmed stress urinary incontinence who had undergone a successful TVT procedure. Ultrasound examination was performed before the TVT procedure and at a median of 3 (range, 3-6) months after surgery. For all women, the changes to the urethra and urinary bladder induced by surgery were examined. For three mobility groups (low, intermediate and high urethral mobility before surgery) we compared the changes induced by the operation and the typical position and mobility of the tape.


RESULTS
The position of the urethra at rest was not influenced by surgery. The operation significantly decreased the mobility of all parts of the urethra during Valsalva. The absolute changes of the vector of the urethral movement differed according to the mobility group (average decrease, 6 mm; decrease for women with low, intermediate and high mobility, respectively, 2-3 mm, 4-6 mm and 9 mm). The change in relative mobility was the same in all groups. The operation decreased funneling (width and depth) during maximal Valsalva. After surgery there was an increase in the thickness of the bladder wall (by 0.64 and 0.73 mm, respectively, at the anterior part and trigone).


CONCLUSIONS
A successful TVT procedure did not influence the position of the urethra at rest but significantly decreased the mobility of the urethra during Valsalva and also decreased funneling at maximal Valsalva.
Masata
J
J
Department of Obstetrics and Gynecology, General Teaching Hospital, Charles University, Prague, Czech Republic. masata@volny.cz
Martan
A
A
Svabik
K
K
Drahoradova
P
P
Pavlikova
M
M
D004548:Elasticity; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011446:Prospective Studies; D053825:Suburethral Slings; D014463:Ultrasonography; D014522:Urethral Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001745:Urinary Bladder Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D014550:Urinary Incontinence, Stress / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*