Intraoperative maximal urethral closing pressure measurement: a new technique of tape tension adjustment in transobturator sling surgery?

PURPOSE: Tape tension adjustment is an essential procedure in mid-urethral sling surgery. The goal of this study was to determine if intraoperative maximal urethral closing pressure (MUCP) elevation could be used as a reference value for adequate tape tension adjustment and predict transobturator (T...

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Main Authors: Myung Beum Kang, Hyeong Gon Kim, Sung Hyun Paick, Yong Soo Lho, Hyoung Keun Park
Format: Article
Language:English
Published: Sociedade Brasileira de Urologia 2011-12-01
Series:International Brazilian Journal of Urology
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382011000600011
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author Myung Beum Kang
Hyeong Gon Kim
Sung Hyun Paick
Yong Soo Lho
Hyoung Keun Park
author_facet Myung Beum Kang
Hyeong Gon Kim
Sung Hyun Paick
Yong Soo Lho
Hyoung Keun Park
author_sort Myung Beum Kang
collection DOAJ
description PURPOSE: Tape tension adjustment is an essential procedure in mid-urethral sling surgery. The goal of this study was to determine if intraoperative maximal urethral closing pressure (MUCP) elevation could be used as a reference value for adequate tape tension adjustment and predict transobturator (TOT) sling surgery outcome. MATERIALS AND METHODS: A prospective study was performed using MUCP measurements just before tape insertion and just after tension adjustment during surgery. Clinical data including preoperative urodynamic results were collected. The cure rate was determined by questionnaire. Patients were divided into two groups. The MUCP elevation group included patients with a MUCP elevation of more than 10 cmH2O before tape insertion; the others were regarded as the non-elevation group. The cure rate and pre- and postoperative clinical variables were compared between the two groups. RESULTS: A total of 48 patients had TOT surgery. The MUCP elevation group (n=19) and the non-elevation group (n=29) were similar with regard to patient characteristics and the preoperative parameters including age, mixed incontinence prevalence, Q-tip angle, peak flow rate, MUCP and the valsalva leak point pressure (VLPP). The mean follow-up period was nine months. The cure rate was significantly higher in the group with MUCP elevation than in the non-elevation group (84% vs. 52%, p=0.02). There was no significant difference in the mean postoperative peak flow rate between the two groups and there was no retention episode. CONCLUSIONS: MUCP elevation of more than 10 cmH2O just after tape insertion was a prognostic factor.
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spelling doaj.art-0fe2be1d8e85413089d2ce2014fc38942022-12-21T17:44:16ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-55381677-61192011-12-0137675175710.1590/S1677-55382011000600011Intraoperative maximal urethral closing pressure measurement: a new technique of tape tension adjustment in transobturator sling surgery?Myung Beum KangHyeong Gon KimSung Hyun PaickYong Soo LhoHyoung Keun ParkPURPOSE: Tape tension adjustment is an essential procedure in mid-urethral sling surgery. The goal of this study was to determine if intraoperative maximal urethral closing pressure (MUCP) elevation could be used as a reference value for adequate tape tension adjustment and predict transobturator (TOT) sling surgery outcome. MATERIALS AND METHODS: A prospective study was performed using MUCP measurements just before tape insertion and just after tension adjustment during surgery. Clinical data including preoperative urodynamic results were collected. The cure rate was determined by questionnaire. Patients were divided into two groups. The MUCP elevation group included patients with a MUCP elevation of more than 10 cmH2O before tape insertion; the others were regarded as the non-elevation group. The cure rate and pre- and postoperative clinical variables were compared between the two groups. RESULTS: A total of 48 patients had TOT surgery. The MUCP elevation group (n=19) and the non-elevation group (n=29) were similar with regard to patient characteristics and the preoperative parameters including age, mixed incontinence prevalence, Q-tip angle, peak flow rate, MUCP and the valsalva leak point pressure (VLPP). The mean follow-up period was nine months. The cure rate was significantly higher in the group with MUCP elevation than in the non-elevation group (84% vs. 52%, p=0.02). There was no significant difference in the mean postoperative peak flow rate between the two groups and there was no retention episode. CONCLUSIONS: MUCP elevation of more than 10 cmH2O just after tape insertion was a prognostic factor.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382011000600011urinary incontinencesuburethral slingstreatment outcomeurodynamics
spellingShingle Myung Beum Kang
Hyeong Gon Kim
Sung Hyun Paick
Yong Soo Lho
Hyoung Keun Park
Intraoperative maximal urethral closing pressure measurement: a new technique of tape tension adjustment in transobturator sling surgery?
International Brazilian Journal of Urology
urinary incontinence
suburethral slings
treatment outcome
urodynamics
title Intraoperative maximal urethral closing pressure measurement: a new technique of tape tension adjustment in transobturator sling surgery?
title_full Intraoperative maximal urethral closing pressure measurement: a new technique of tape tension adjustment in transobturator sling surgery?
title_fullStr Intraoperative maximal urethral closing pressure measurement: a new technique of tape tension adjustment in transobturator sling surgery?
title_full_unstemmed Intraoperative maximal urethral closing pressure measurement: a new technique of tape tension adjustment in transobturator sling surgery?
title_short Intraoperative maximal urethral closing pressure measurement: a new technique of tape tension adjustment in transobturator sling surgery?
title_sort intraoperative maximal urethral closing pressure measurement a new technique of tape tension adjustment in transobturator sling surgery
topic urinary incontinence
suburethral slings
treatment outcome
urodynamics
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382011000600011
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AT sunghyunpaick intraoperativemaximalurethralclosingpressuremeasurementanewtechniqueoftapetensionadjustmentintransobturatorslingsurgery
AT yongsoolho intraoperativemaximalurethralclosingpressuremeasurementanewtechniqueoftapetensionadjustmentintransobturatorslingsurgery
AT hyoungkeunpark intraoperativemaximalurethralclosingpressuremeasurementanewtechniqueoftapetensionadjustmentintransobturatorslingsurgery