title: Impact of concomitant anterior vaginal reconstructive surgery on transobturator suburethral tape procedures.
abstract: OBJECTIVE
  To explore the functional and morphological impact of concomitant anterior vaginal reconstructive surgery on outcome of transobturator suburethral tape (TOT) procedures.
  
  
  METHODS
  This was a retrospective review and analysis of data from 196 women who had undergone a TOT procedure with or without concomitant anterior vaginal reconstructive surgery during a 30-month period. Retrieved data included clinical information and ultrasound findings. Ultrasound examinations assessed the tape location and tape tension at rest, on straining and during coughing. Ultrasound parameters representing tape location comprised the sagittal tape-symphysis pubis distance, sagittal tape-symphysis pubis angle and tape percentile (an indication of tape position along the urethra with respect to urethral length); those representing tape tension included urethral encroachment, sagittal tape-urethra distances at the upper end, central point and lower end of the tape and axial urethral central echolucent area at the center of the tape.
  
  
  RESULTS
  Of the 196 women, 117 had undergone a TOT procedure without concomitant anterior vaginal surgery (Group 1), 44 had undergone TOT placement with anterior colporrhaphy (Group 2) and 35 had undergone TOT placement with a transobturator vaginal mesh procedure (Group 3). At the 3-month follow-up, functional outcomes as well as resting and dynamic ultrasound findings were similar between women following TOT procedures without (Group 1) and with (Groups 2 and 3) concomitant anterior vaginal surgery. However, a significantly higher rate of urethral encroachment at rest was noted in Group 2.
  
  
  CONCLUSIONS
  Concomitant anterior vaginal reconstructive surgery neither aggravates the functional outcome nor affects the ultrasound findings of TOT procedures.
authors.affiliation: Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan.
authors.forename: W-C
authors.initials: WC
authors.lastname: Huang
authors.forename: S-H
authors.initials: SH
authors.lastname: Yang
authors.forename: J-M
authors.initials: JM
authors.lastname: Yang
authors.forename: C-R
authors.initials: CR
authors.lastname: Tzeng
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D053825:Suburethral Slings; D013526:Surgical Mesh; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014463:Ultrasonography; D014521:Urethra / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*