Transvulvar ultrasound of urethrovesical junction and proximal urethra as prognostic markers of burch procedure outcome

Abstract

Objective: To compare sonographic pre- and post-op parameters related to the urethrovesical junction (UVJ) and proximal urethra (PU) in women with stress urinary incontinence (SUI) surgically cured or not with the Burch procedure, and to evaluate whether these can be used as prognostic markers.

Methods: Thirty female patients were selected by convenience sampling and assigned into two groups: 15 patients considered as clinically cured (the case group) and 15 as not cured (the control group). The enrollees were submitted to pre- (30 days prior) and post-op (180 days after) transvulvar ultrasound assessments of the UVJ and PU.

Results: On post-op assessments measured on strain, the vertical UVJ distance from the inferior pubic border and the PU length were significantly larger in cured patients (12.87 ± 5.80mm vs 5.13 ± 6.55mm in controls, P<0.01; and 13.07 ± 6.44mm vs 6.20 ± 6.14mm in controls, P<0.01) respectively. The vertical UVJ displacement or descent and PU displacement or variation were significantly shorter in cured patients (8.47 ± 3.98mm vs 5.13 ± 2.36mm in controls, P< 0.001; and 8.33 ± 4.54mm vs 5.20 ± 2.90mm in controls, P< 0.05) respectively. More importantly, on pre-op assessments, only the PU displacement or variation was significantly larger in cured patients (15.87 ± 4.55mm vs 12.47 ± 3.52 mm in controls, P<0.05).

Conclusions: Transvulvar ultrasound of the UVJ and PU can be used as prognostic markers of surgical outcomes in women with SUI treated with the Burch procedure.