Sonographic Sling Position and the Outcome of the Tension-Free Vaginal Tape-Obturator in Asian Chinese

Introduction and hypothesis: The objective was to assess the sonographic tension-free vaginal tape-obturator (TVT-O) position and the outcome in Asian Chinese women.

Methods: A prospective cohort study of 254 patients who underwent TVT-O surgery between 2013 and 2022. The sonographic position of the TVT-O was recorded and correlated with the outcomes, including the subjective cure rates, Incontinence Impact Questionnaire 7 (IIQ-7), and retention of urine.

Results: A total of 92.9% reported no stress urinary incontinence after the operation. The IIQ-7 score significantly improved after TVT-O surgery. 88.2% of patients had the TVT-O placed at 50-70% of the urethral length and half of the TVT-O were placed 3-5 mm from the urethra. The cure rate was higher when the tape was in the middle third of the urethra, but the tape position was not associated with postoperative retention of urine in our study.

Conclusions: Most TVT-Os can be placed in the target zone in a blind procedure in Asian Chinese women. The tape position was related to the outcomes. Early postoperative ultrasound of the tape position may predict the outcome of the surgery.