Urethral hypermobility after anti-incontinence surgery - a prognostic indicator?

International Urogynecology Journal and Pelvic Floor Dysfunction
Volker ViereckGünter Emons

Abstract

The aim of this study was to define the concept of hypermobility of the bladder neck and determine its effects on the cure rate and postoperative complications in patients undergoing colposuspension. In a retrospective study, 310 patients who underwent primary colposuspension for urodynamically proven genuine stress urinary incontinence were assessed by introital ultrasound before surgery and during follow-up for up to 48 months postoperatively. A total of 152 women completed 48 months of follow-up. Mobility of the bladder neck during straining was described as linear dorsocaudal movement (LDM) with LDM >15 mm being defined as hypermobility. The overall objective cure rate was 90.0% at 6-month follow-up vs 76.8% at 48-month follow-up (Kaplan-Meier estimators). Urge symptoms occurred in 12.6% (39/310) of the women and de novo urge incontinence in 2.3% (7/310). Bladder neck hypermobility was significantly reduced after anti-incontinence surgery, from 67.1% (208/310) before surgery to 5.5% (17/310) immediately after surgery (P<0.0001). Postoperative hypermobility was associated with a higher recurrence rate. In the hypermobility group, 52.9 and 34.0% of the patients were continent for up to 6 and 48 months, respectively, as oppose...Continue Reading

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Citations

Mar 6, 2010·International Urogynecology Journal·Jacek KociszewskiVolker Viereck
May 27, 2009·Indian Journal of Urology : IJU : Journal of the Urological Society of India·Frederico Teixeira BrandtRaíssa Almeida Viana
Jan 23, 2016·International Urogynecology Journal·Anne-Cécile PizzoferratoXavier Fritel
Feb 23, 2010·The Journal of Urology·Ka Lai ShekHans Peter Dietz
Feb 22, 2008·Neurourology and Urodynamics·Jacek KociszewskiVolker Viereck
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Sep 2, 2014·Neurourology and Urodynamics·Volker ViereckJacek Kociszewski
Sep 27, 2015·Archives of Gynecology and Obstetrics·Stefan AlbrichChristine Skala

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