Three-dimensional ultrasound of the urethral sphincter predicts continence surgery outcome

Neurourol Urodyn. 2009;28(1):90-4. doi: 10.1002/nau.20566.

Abstract

Aim: To assess the predictive value of three-dimensional (3D) ultrasound volumes of the urethral sphincter in women undergoing continence surgery.

Materials and methods: Women with urodynamic stress incontinence undergoing to Burch colposuspension were prospectively studied using videocystourethrography (VCU), urethral pressure profilometry (UPP) and a 3D transvaginal ultrasound scan of the urethra. The total urethral sphincter volume, urethral volume, maximum cross sectional area, and rhabdosphincter volume were calculated, preoperatively. Surgical outcome was assessed at 6 months using VCU. Urethral function parameters were correlated to surgical outcomes using the Mann-Whitney U-test.

Results: Ninety-one women were studied. Women who failed continence surgery had significantly smaller preoperative urethral sphincter volumes than those who had an objective cure (P < 0.001). UPP parameters were not found to be predictive of surgical outcome (P = 0.5).

Conclusions: The assessment of the urethral sphincter using a 3D ultrasound scan predicts the outcome of continence surgery.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted*
  • Imaging, Three-Dimensional*
  • Middle Aged
  • Predictive Value of Tests
  • Pressure
  • Prospective Studies
  • Recurrence
  • Treatment Failure
  • Ultrasonography
  • Urethra / diagnostic imaging*
  • Urethra / physiopathology
  • Urinary Bladder / physiopathology
  • Urinary Incontinence, Stress / diagnostic imaging*
  • Urinary Incontinence, Stress / physiopathology
  • Urinary Incontinence, Stress / surgery*
  • Urodynamics
  • Urologic Surgical Procedures*