title: Three-dimensional ultrasound assessment and middle term efficacy of a single-incision sling.
abstract: OBJECTIVE
  The aim of this study was to evaluate the functional outcome of a single-incision sling procedure for the treatment of female stress urinary incontinence (SUI) and to correlate the cure rate with a pelvic floor ultrasound examination
  
  
  METHODS
  Fifty-seven patients treated with a single-incision sling procedure between January 2009 and September 2010 were included in the study. Functional outcome was evaluated as objective cure rate assessed with stress test and subjective cure rate determined by the International Consultation on Incontinence-Short Form and Patient Global Impression of Improvement scores. Women underwent perineal ultrasound examination by a combined 2D translabial and 3D transvaginal approach to assess bladder neck and tape mobility, tape position along the urethral axis, and tape anchorage. According to the position of self-fixating tips, we divided patients into group A (both tips crossed the obturator membrane), group B (only one tip crossed the obturator membrane) and group C (none of the tips crossed the obturator membrane). Objective cure rate and type of anchorage were compared with all ultrasound parameters.
  
  
  RESULTS
  At an average follow-up of 13 months objective cure rate was 87.7 % with a significant subjective improvement. A significant difference in tape mobility was noted between group A and group C. Bladder neck mobility significantly increased in failures. Sling was significantly closer to mid-urethra in cured than in failures.
  
  
  CONCLUSIONS
  In 77 % of patients MA didn't reach the obturator membrane on both sides. This feature conditioned significantly bladder neck mobility but not the efficacy of the procedure. Tape position seems to be the most important factor for success.
authors: Università Milano Bicocca, Azienda Ospedaliera San Gerardo, Monza, Italy. federico.spelzini@gmail.com
authors: Federico
authors: F
authors: Spelzini
authors: Maria Cristina
authors: MC
authors: Cesana
authors: Debora
authors: D
authors: Verri
authors: Serena
authors: S
authors: Polizzi
authors: Matteo
authors: M
authors: Frigerio
authors: Rodolfo
authors: R
authors: Milani
mesh_terms: D000328:Adult; D000368:Aged; D019160:Endosonography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D053825:Suburethral Slings; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology; D014550:Urinary Incontinence, Stress / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics / Q000502:physiology