Introital ultrasound in the diagnosis of lower urinary tract symptoms following anti-incontinence surgery using a synthetic midurethral tape

Abstract

Introduction and hypothesis: Surgical treatment of stress urinary incontinence in women using a synthetic midurethral tape has become a standard procedure. One of the complications observed postoperatively are lower urinary tract symptoms (LUTS). The aim was to analyze the role of introital ultrasound in the identification of patients at risk for developing LUTS after surgical treatment using synthetic tape. Methods: A group of 50 patients suffering from LUTS following anti-incontinence surgery using synthetic tape was included in this study. The patients with pelvic organ prolapse and coexisting overactive bladder-wet before surgery were excluded. The control group consisted of 50 patients after the same treatment without any complications and with a good outcome. Tape visualization was performed using introital two-dimensional ultrasound. The assessment of the Tape Index (T/U) enabled us to divide the study group into the two subgroups with the tape index value of 0.375 as a borderline. The correlation between the tape position and the occurrence of LUTS was evaluated using a Chi-squared test. Results: In the group of patients suffering from LUTS, the tape was found to be closer to the bladder neck (the lower edge of the tape was more than 37.5% of the urethral length) and it was statistically significant (Chi-squared = 19.87, p < 0.001). Conclusions: The tape position in the proximal urethra may have an impact on the postoperative occurrence of LUTS. The simple method of introital ultrasound could allow the identification of patients at risk for the development of LUTS after anti–incontinence surgery using synthetic tape.