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Dynamic assessment of sling function on transperineal ultrasound: does it correlate with outcomes 1 year following surgery?

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Abstract

Introduction and hypothesis

To correlate dynamic assessment of sling function using 2D and 3D transperineal ultrasound with outcomes following transobturator sling surgery.

Methods

This is an unmatched case–control study of 100 patients who underwent transobturator sling surgery at our center between 2009 and 2012. Group A (n = 50) patients had successful outcomes and group B (n = 50) patients had suboptimal outcomes 1 year following surgery. The patients underwent 2D dynamic and 3D transperineal ultrasound. The two groups were compared with regard to the deformability of the sling on Valsalva, the concordance of urethral movement with the sling, and location of the sling.

Results

When compared with group B, group A had a significantly greater number of patients in whom the sling deformed at Valsalva (flat at rest, curving into a c-shape at Valsalva), the urethral movement was concordant with the sling and the sling had a midurethral location (p < 0.0001). In all 17 patients in group B in whom the urethra moved in a concordant manner with the sling (34%), the sling did not deform on Valsalva maneuver and was located proximally. In all 15 patients in group A in whom the sling remained either flat or curved (30%), the urethra moved concordant with the sling and the sling was in midurethral location.

Conclusions

On 2D and 3D transperineal ultrasound, the best outcomes following transobturator sling surgery are associated with concordance of urethral movement with the sling, midurethral location, and deformability of the sling on dynamic assessment.

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Authors and Affiliations

  1. Center for Urogynecology and Pelvic Health (C.U.P), New Delhi, India

    Aparna Hegde

  2. Department of Gynecology, Section of Urogynecology and Reconstructive Pelvic Surgery, Cleveland Clinic Florida, Weston, FL, USA

    Aparna Hegde, Mayte Nogueiras, Vivian C. Aguilar & G. Willy Davila

Authors
  1. Aparna Hegde
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  2. Mayte Nogueiras
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  3. Vivian C. Aguilar
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  4. G. Willy Davila
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Corresponding author

Correspondence to Aparna Hegde.

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Conflicts of interest

A. Hegde was funded by IUGA International Fellowship Grant Award, 2011.

G.W. Davila: consultant for and honoraria from Astellas, Watson, American Medical Systems, Novasys Medical, CL Medical; research funding from American Medical Systems, Astellas.

The other authors declare that they have no disclosures to make.

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Hegde, A., Nogueiras, M., Aguilar, V.C. et al. Dynamic assessment of sling function on transperineal ultrasound: does it correlate with outcomes 1 year following surgery?. Int Urogynecol J 28, 857–864 (2017). https://doi.org/10.1007/s00192-016-3234-y

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  • DOI: https://doi.org/10.1007/s00192-016-3234-y

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