The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery

SERTER, Selim; TEMELTAŞ, Gökhan; GÜMÜŞ, Bilali; göktan, cihan; Tarhan, Serdar; YILMAZ OVALI, Gülgün

The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery

Serdar TARHAN, (Celal Bayar Üniversitesi, Tıp Fakültesi, Radyoloji Anabilim Dalı, Manisa, Türkiye)

Bilali GÜMÜŞ, (Celal Bayar Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, Manisa, Türkiye)

Gökhan TEMELTAŞ, (Celal Bayar Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, Manisa, Türkiye)

Gülgün YILMAZ OVALI, (Celal Bayar Üniversitesi, Tıp Fakültesi, Radyoloji Anabilim Dalı, Manisa, Türkiye)

Selim SERTER, (Celal Bayar Üniversitesi, Tıp Fakültesi, Radyoloji Anabilim Dalı, Manisa, Türkiye)

Cihan GÖKTAN (Celal Bayar Üniversitesi, Tıp Fakültesi, Radyoloji Anabilim Dalı, Manisa, Türkiye)

Turkish Journal of Medical Sciences

1 0

Yıl: 2010 Cilt: 40 Sayı: 4 Sayfa Aralığı: 549 - 556 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery

Öz:

Amaç: Bu çalışmanın amacı pubovajinal sling operasyonu ile tedavi edilen hastalarda postoperatif MRG bulguları ile inkontinans şiddet indeksi arasındaki ilişkiyi araştırmaktır.Yöntem ve gereç: Pubovajinal sling operasyonu geçirmiş 52 kadın hasta çalışmaya dahil edildi. Postoperatif altıncı ayda hastaların inkontinans şiddet indeksleri değerlendirildi. Aynı gün hastaların MRG incelemeleri de yapıldı. Hastalardan istirahatta ve maksimum ıkınma sırasında simfisis, üretra ve koksiksi de içerecek şekilde T2-A sagittal görüntüler elde edildi. Her hasta için mesane tabanının mobilitesi ve posterior üretrovezikal açı değişiklikleri hesaplandı. İnkontinans şiddet indeksi ile mesane tabanı mobilitesi ve posterior üretrovezikal açı değişiklikleri arasındaki ilişki SPSS programı ile Sperman's Rho korelasyon testi kullanılarak analiz edildi.Bulgular: İnkontinans şiddet indeksi ile mesane boynu mobilitesi arasında ve şiddet indeksi ile posterior üretrovezikal açının derecesi arasında pozitif korelasyon saptandı (sırasıyla, r = 0,797, P = 0,000; r = 0,62, P = 0,000). Valsalva manevrası sırasında posterior üretrovezikal açıdaki artış ile inkontinans şiddet indeksi arasında da pozitif korelasyon görüldü (r = 0,47, P = 0,02). Sonuç: MRG stres üriner inkontinanslı hastalarda mesane tabanının pozisyonunun, mesane boynu mobilitesinin ve posterior üretrovezikal açının değerlendirilmesinde noninvaziv bir tanı yöntemidir. Stres üriner inkontinansın postoperatif takibinde önemli rol oynayabilir. MRG pubovajinal sling cerrahisinin başarısının değerlendirilmesinde de kullanılabilir.

Anahtar Kelime:

Konular: Cerrahi

Pubovajinal sling operasyonu sonrası inkontinans şiddet indeksi ile MRG bulgularının karşılaştırılması

Öz:

Aim: To investigate the relationship between postoperative MRI findings and the severity score of incontinence in patients treated with pubovaginal sling surgery.Materials and methods: Fifty-two female patients treated with pubovaginal slings were included in the study. These patients’ severity scores of incontinence were evaluated in the postoperative 6 th month. All the patients were examined using MRI on the same day. A T2-weighted sagittal image of the midline structures, including the symphysis, urethra, and coccyx, was obtained at rest and at maximal strain. The mobility of the bladder floor and change in the posterior urethrovesical angle were calculated for each patient. Relationships between the severity score of incontinence and mobility of the bladder floor and change in the posterior urethrovesical angle were analyzed using Spearman's rank correlation coefficients by means of SPSS.Results: A positive correlation was found between the severity score of incontinence and the mobility of the bladder neck and also between the score and the degree of posterior urethrovesical angle (r = 0.797, P = 0.000; r = 0.62, P = 0.000, respectively). There was also a positive correlation between the severity score of incontinence and the increase in posterior urethrovesical angle during Valsalva's maneuver (r = 0.47, P = 0.02).Conclusion:MRI is a non-invasive diagnostic method for the evaluation of bladder floor position, mobility of the bladder neck, and posterior urethrovesical angle in patients with stress urinary incontinence. It can play a major role in the postoperative follow up of stress urinary incontinence. MRI can also be used for the assessment of success in pubovaginal sling surgery.

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Fielding JR, Griiths DJ, Versi E, Mulkern RV, Lee MLT, Jolesz FA. MR imaging of pelvic loor continence mechanisms in the supine and sitting positions. AJR 1998; 171: 1607-10.
2. Yang A, Mostwin JL, Rosenheim NB, Zerhouni EA. Pelvic loor descent in women: dynamic evaluation with fast MR imaging and cinematic display. Radiology 1991; 179: 25-33.
3. Wijma J, Potters AE, de Wolf BT, Tinga DJ, Arnoudse JG. Anatomical and functional changes in the lower urinary tract following spontaneous vaginal delivery. BJOG 2003; 110: 658-63.
4. Sartori JP, Sartori MG, Baracat EC, de Lima GR, Girão MJ. Bladder neck mobility and functional evaluation of the pelvic loor in primiparae according to the type of delivery. Clin Exp Obstet Gynecol 2004; 31: 120-2.
5. Baytur YB, Serter S, Tarhan S, Uyar Y, Inceboz U, Pabuscu Y. Pelvic loor function and anatomy ater childbirth. J Reprod Med 2007; 52: 604-10.
6. DeLancey JOL. Structural aspects of extrinsic continence mechanism. Obstet Gynecol 1988; 72: 296-301.
7. Unterweger M, Marincek B, Gottstein-Aalame N, Debatin JF, Seifert B, Ochsenbein-Imhof N et al. Ultrafast MR imaging of pelvic loor. AJR 2001; 176: 959-63.
8. Pelsang RE, Bonney WW. Voiding cystourethrography in female stress incontinence. AJR 1996; 166: 561-5.
9. Huddleston HT, Dunnihoo DR, Huddleston PM, Meyers PC. Magnetic resonance imaging of defect in DeLancey's vaginal support levels, I, II and III. Am J Obstet Gynecol 1995; 172: 1778-84.
10. Lienemann A, Anthuber C, Baron A, Kohz C, Reiser M. Dynamic MR colpocystorectography assessing pelvic-loor descent. Eur Radiol 1997; 7: 1309-17.
11. Schaer GN, Koechli OR, Schuessler B, Haller U. Perineal ultrasound for evaluating the bladder neck in urinary stress incontinence. Obstet Gynecol 1995; 85: 220-4.
12. Giordano P, Drew PJ, Taylor D, Duthie G, Lee PW, Monson JR. Vaginography: investigation of choice for clinically suspected vaginal istulas. Dis Colon Rectum 1996; 39: 568-72.
13. Seifert H, Blass G, Leetz HK. Zur bestimmung der ovarialdosis bei der defakographie an einem digitalen c-bogen. Rofo Fortschr Rontgen 1994; 161: 70-4.
14. Huang WC, Yang SH, Yang JM. Anatomical and functional signiicance of urogenital hiatus in primary urodynamic stress incontinence. Ultrasound Obstet Gynecol 2006; 27: 71-7.
15. Balmforth JR, Mantle J, Bidmead J, Cardozo L. A prospective observational trial of pelvic loor muscle training for female stress urinary incontinence. BJU Int 2006; 98: 811-7.
16. Comiter CV, Vasavada SP, Barbaric ZL, Gousse AE, Raz S. Grading pelvic prolapse and pelvic loor relaxation using dynamic magnetic resonance imaging. Urology 1999; 54: 454-7
17. Barrington JW, Abdel-Fattah M, Arunkalaivanan AS, Austin S, Isaacs J. Longitudinal study of pelvicol pubovaginal slings using magnetic resonance imaging. J Obstet Gynaecol 2004; 24: 542-6.
18. Guler H, Ohde A, Grau G, Grossmann A. Colpocystoproctography in the upright and supine positions correlated with dynamic MRI of the pelvic loor. Eur J Radiol 2004; 51: 41-7.
19. Gufer H, Laubenberger J, DeGregorio G, Dohnicht S, Langer M. Pelvic loor descent: dynamic MR imaging using a half- fourier RARE sequence. J Magn Reson Imaging 1999; 9: 378-83.
20. Vanbeckevoort D, Van Hoe L, Oyen R, Ponette E, De Ridder D, Deprest J. Pelvic loor descent in females: comparative study of colpocystodefecography and dynamic fast MR imaging. J Magn Reson Imaging 1999; 9: 373-7.
21. Goh V, Halligan S, Kaplan G, Heally J, Bartam C. Dynamic MR imaging of the pelvic loor in asymptomatic subjects. AJR 2000; 174: 661-6.
22. Lienemann A, Fischer T. Functional imaging of the pelvic loor. Eur J Radiol 2003; 47: 117-22.
23. Hsu Y, Summers A, Hussain HK, Guire KE, Delancey JO. Lovator plate angle in women with pelvic organ prolapsed compared to women with normal support using dynamic MR imaging. Am J Obstet Gynecol 2006; 194: 1427-33.
24. McGuire EJ, O'Connell HE. Surgical treatment of intrinsic urethral dysfunction: slings. Urol Clin North Am 1995; 22: 657-64.
25. Young SB, Howard AE, Illanes DS, Weber Lebrun EE, Hardy JR, Kambiss SM et al. Long-term eicacy of the pubovaginal Mersilene mesh sling. Am J Obstet Gynecol 2009; 201: 516.e1-7.
26. Noblett KL, Shen B, Lane FL. Lynx midurethral sling system: a 1-year prospective study on eicacy and safety. Int Urogynecol J Pelvic Floor Dysfunct 2008; 19: 1217-21.
27. Lee JH, Kim KH, Lee HW, Kim KH, Choi JS, Yoon SJ et al. Distal urethral polypropylene sling surgical management for urodynamic stres incontinence in Korean women. Urol Int 2009; 82: 191-5.
28. Pianezza ML, Jofe R, Chugh T, Radomski SB. Long-term patient satisfaction following cadaveric pubovaginal sling incontinence surgery using the UDI and IIQ-7 questionnaires. Neurourol Urodyn 2007; 26: 185-9.
29. Petros PE, Richardson PA. Midurethral tissue ixation system (TFS) sling for cure of stress incontinence—3 year results. Int Urogynecol J Pelvic Flor Dysfunct 2008; 19: 869-71.
30. Mitsui T, Tanaka H, Moriya K, Kakizaki H, Nonomura K. Clinical and urodynamic outcomes of pubovaginal sling procedure with autologous rectus fascia for stress urinary incontinence. Int J Urol 2007; 14: 1076-9.
31. Rodrigues FR, Maroccolo Filho R, Maroccolo RR, Paiva LC, Diaz FA, Ribeiro EC. Pubovaginal sling with a low-cost polypropylene mesh. Int Braz J Urol 2007; 33: 690-4.
32. Shariiaghdas F, Mortazavi N. Tension-free vaginal tape and autologous rectus fascia pubovaginal sling for the treatment of urinary stress incontinence: a medium-term follow-up. Med Princ Pract 2008; 17: 209-14.
33. Jeon MJ, Jung HJ, Chung SM, Kim SK, Bai SW. Comparison of the treatment outcome of pubovaginal sling, tension-free vaginal tape, and transobturator tape for stress urinary incontinence with intrinsic sphincter deiciency. Am J Obstet Gynecol 2008; 199: 76.e1-4.
34. Liapis A, Bakas P, Creatsas G. Tension-free vaginal tape in the management of recurrent urodynamic stress incontinence ater previous failed midurethral tape Eur Urol 2009; 55: 1450-5.
35. Cholhan HJ, Lotze PM. Urodynamic changes ater tension-free sling procedures: Mycromesh-Plus vs TVT sling. Int Urogynecol J Pelvic Floor Dysfunct 2008; 19: 217-25.
36. Lo TS, Lee SJ. Simple sling resection and a second, intermediate polypropylene mesh for treatment of vaginal tape protrusion concurrent with recurrent urinary stress incontinence ater TVT procedure. J Obstet Gynaecol Res 2007; 33: 739-42.
37. Zullo MA, Ruggiero A, Plotti F, Bellati F, Basile S, Manci N et al. Anterior colporrhaphy plus inside-out tension-free vaginal tape for associated stress urinary incontinence and cystocele. J Minim Invasive Gynecol 2008; 15: 446-51.
38. Schierlitz L, Dwyer PL, Rosamilia A, Murray C, homas E, De Souza A et al. Efectiveness of tension-free vaginal tape compared with transobturator tape in women with stress urinary incontinence and intrinsic sphincter deiciency: a randomized controlled trial. Obstet Gynecol 2008; 112: 1253-61.
39. Sartori JP, Martins JA, Castro Rde A, Sartori MG, Girão MJ. Pubovaginal sling and tension-free vaginal tape for surgical treatment of stress urinary incontinence in women. Rev Bras Ginecol Obstet 2008; 30: 127-34.
40. Liapis A, Bakas P, Creatsas G. Long-term eicacy of tension- free vaginal tape in the management of stress urinary incontinence in women: eicacy at 5- and 7-year follow-up. Int Urogynecol J Pelvic Floor Dysfunct 2008; 19: 1509-12.
41. Lee JH, Yoon HJ, Lee SJ, Kim KH, Choi JS, Lee KW. Modiied transobturator tape (canal transobturator tape) surgery for female stress urinary incontinence. J Urol 2009; 181: 2616-21.
42. Chene G, Amblard J, Tardieu AS, Escalona JR, Viallon A, Fatton B et al. Long-term results of tension-free vaginal tape (TVT) for the treatment of female urinary stress incontinence. Eur J Obstet Gynecol Reprod Biol 2007; 134: 87-94.
43. Güngördük K, Çelebi I, Ark C, Çelikkol O, Yıldırım G. Which type of mid-urethral sling procedure should be chosen for treatment of stress urinary incontinance with intrinsic sphincter deiciency? Tension-free vaginal tape or transobturator tape. Acta Obstet Gynecol Scand 2009; 88: 920-6.

APA	Tarhan S, GÜMÜŞ B, TEMELTAŞ G, YILMAZ OVALI G, SERTER S, göktan c (2010). The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery. , 549 - 556.
Chicago	Tarhan Serdar,GÜMÜŞ Bilali,TEMELTAŞ Gökhan,YILMAZ OVALI Gülgün,SERTER Selim,göktan cihan The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery. (2010): 549 - 556.
MLA	Tarhan Serdar,GÜMÜŞ Bilali,TEMELTAŞ Gökhan,YILMAZ OVALI Gülgün,SERTER Selim,göktan cihan The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery. , 2010, ss.549 - 556.
AMA	Tarhan S,GÜMÜŞ B,TEMELTAŞ G,YILMAZ OVALI G,SERTER S,göktan c The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery. . 2010; 549 - 556.
Vancouver	Tarhan S,GÜMÜŞ B,TEMELTAŞ G,YILMAZ OVALI G,SERTER S,göktan c The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery. . 2010; 549 - 556.
IEEE	Tarhan S,GÜMÜŞ B,TEMELTAŞ G,YILMAZ OVALI G,SERTER S,göktan c "The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery." , ss.549 - 556, 2010.
ISNAD	Tarhan, Serdar vd. "The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery". (2010), 549-556.

APA	Tarhan S, GÜMÜŞ B, TEMELTAŞ G, YILMAZ OVALI G, SERTER S, göktan c (2010). The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery. Turkish Journal of Medical Sciences, 40(4), 549 - 556.
Chicago	Tarhan Serdar,GÜMÜŞ Bilali,TEMELTAŞ Gökhan,YILMAZ OVALI Gülgün,SERTER Selim,göktan cihan The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery. Turkish Journal of Medical Sciences 40, no.4 (2010): 549 - 556.
MLA	Tarhan Serdar,GÜMÜŞ Bilali,TEMELTAŞ Gökhan,YILMAZ OVALI Gülgün,SERTER Selim,göktan cihan The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery. Turkish Journal of Medical Sciences, vol.40, no.4, 2010, ss.549 - 556.
AMA	Tarhan S,GÜMÜŞ B,TEMELTAŞ G,YILMAZ OVALI G,SERTER S,göktan c The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery. Turkish Journal of Medical Sciences. 2010; 40(4): 549 - 556.
Vancouver	Tarhan S,GÜMÜŞ B,TEMELTAŞ G,YILMAZ OVALI G,SERTER S,göktan c The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery. Turkish Journal of Medical Sciences. 2010; 40(4): 549 - 556.
IEEE	Tarhan S,GÜMÜŞ B,TEMELTAŞ G,YILMAZ OVALI G,SERTER S,göktan c "The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery." Turkish Journal of Medical Sciences, 40, ss.549 - 556, 2010.
ISNAD	Tarhan, Serdar vd. "The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery". Turkish Journal of Medical Sciences 40/4 (2010), 549-556.