Association between sonographic sling location and success of surgery for stress urinary incontinence

Ultrasound Obstet Gynecol. 2023 Jul;62(1):143-147. doi: 10.1002/uog.26142. Epub 2023 Jun 12.

Abstract

Objective: To determine the relationship between the clinical outcome of suburethral sling surgery for stress urinary incontinence and sling location on ultrasound examination.

Methods: This was a retrospective study of patients diagnosed with stress urinary incontinence who were treated with a suburethral sling by a single surgeon between January 2009 and October 2016. Four-dimensional volumes acquired on transperineal ultrasound at least 3 months postoperatively were analyzed and the gap between the sling and symphysis pubis (sling-pubis gap (SPG)) on Valsalva maneuver was measured. Continence was assessed on a cough stress test at follow-up.

Results: A total of 378 patients were included, with a mean follow-up of 14.3 months. The success rate of sling surgery was 89.4%. The mean ± SD SPG on Valsalva maneuver was 12.0 ± 2.5 mm in women who were clinically continent at follow-up and 14.1 ± 2.8 mm in those with failed surgery (P < 0.001).

Conclusion: A shorter SPG on transperineal ultrasound imaging after suburethral sling surgery is associated with cure of stress urinary incontinence. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

Keywords: sling-symphysis pubis gap; stress urinary incontinence; suburethral sling procedure; ultrasound.

MeSH terms

  • Female
  • Humans
  • Retrospective Studies
  • Suburethral Slings*
  • Treatment Outcome
  • Ultrasonography
  • Urinary Incontinence, Stress* / diagnostic imaging
  • Urinary Incontinence, Stress* / surgery