The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery

Authors: SERDAR TARHAN, BİLALİ GÜMÜŞ, GÖKHAN TEMELTAŞ, GÜLGÜN YILMAZ OVALI, SELİM SERTER, CİHAN GÖKTAN

Abstract: To investigate the relationship between postoperative MRI findings and the severity score of incontinence in patients treated with pubovaginal sling surgery. Materials and methods: Fifty-two female patients treated with pubovaginal slings were included in the study. These patients' severity scores of incontinence were evaluated in the postoperative 6th month. All the patients were examined using MRI on the same day. A T2-weighted sagittal image of the midline structures, including the symphysis, urethra, and coccyx, was obtained at rest and at maximal strain. The mobility of the bladder floor and change in the posterior urethrovesical angle were calculated for each patient. Relationships between the severity score of incontinence and mobility of the bladder floor and change in the posterior urethrovesical angle were analyzed using Spearman's rank correlation coefficients by means of SPSS. Results: A positive correlation was found between the severity score of incontinence and the mobility of the bladder neck and also between the score and the degree of posterior urethrovesical angle (r = 0.797, P = 0.000; r = 0.62, P = 0.000, respectively). There was also a positive correlation between the severity score of incontinence and the increase in posterior urethrovesical angle during Valsalva's maneuver (r = 0.47, P = 0.02). Conclusion: MRI is a non-invasive diagnostic method for the evaluation of bladder floor position, mobility of the bladder neck, and posterior urethrovesical angle in patients with stress urinary incontinence. It can play a major role in the postoperative follow up of stress urinary incontinence. MRI can also be used for the assessment of success in pubovaginal sling surgery.

Keywords: Urinary incontinence, magnetic resonance imaging, pubovaginal slings

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