Three-dimensional ultrasound of the urethral sphincter predicts continence surgery outcome.
OBJECTIVE
To assess the predictive value of three-dimensional (3D) ultrasound volumes of the urethral sphincter in women undergoing continence surgery.


METHODS
Women with urodynamic stress incontinence undergoing to Burch colposuspension were prospectively studied using videocystourethrography (VCU), urethral pressure profilometry (UPP) and a 3D transvaginal ultrasound scan of the urethra. The total urethral sphincter volume, urethral volume, maximum cross sectional area, and rhabdosphincter volume were calculated, preoperatively. Surgical outcome was assessed at 6 months using VCU. Urethral function parameters were correlated to surgical outcomes using the Mann-Whitney U-test.


RESULTS
Ninety-one women were studied. Women who failed continence surgery had significantly smaller preoperative urethral sphincter volumes than those who had an objective cure (P < 0.001). UPP parameters were not found to be predictive of surgical outcome (P = 0.5).


CONCLUSIONS
The assessment of the urethral sphincter using a 3D ultrasound scan predicts the outcome of continence surgery.
Digesu
G Alessandro
GA
Department of Urogynaecology, Imperial College, Cambridge Wing, St. Mary's Hospital, London, United Kingdom. digesualex@hotmail.com
Robinson
Dudley
D
Cardozo
Linda
L
Khullar
Vik
V
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D011237:Predictive Value of Tests; D011312:Pressure; D011446:Prospective Studies; D012008:Recurrence; D017211:Treatment Failure; D014463:Ultrasonography; D014521:Urethra / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001743:Urinary Bladder / Q000503:physiopathology; D014550:Urinary Incontinence, Stress / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures