Variability of Urethral Length Evaluated Using Introital Ultrasonography and Its Value a Priori in Mid-Urethral Tape Positioning

Tommaselli GA1 , Luffarelli P2*, Schiavi MC3 , Formisano C1 , Fabozzi A1 , Zullo MA2

1 Department of Neurosciences, Reproductive and Odontostomatologic Sciences, University of Naples, Italy 2 Department of Pelvic Floor Surgery and Proctology, University of Rome, Italy 3 Department of Gynecology and Obstetrics, La Sapienza University, Italy

^*Correspondance to: Paolo Luffarelli 

 PDF  Full Text DOI: 10.25107/2474-1647.2982

Abstract

Purpose: The aim was to evaluate the variability of urethral length and determine if this variability may have a clinical relevance for mid-urethral tape positioning using the classic vaginal incision. Methods: This is an observational study on 205 patients undergoing transvaginal ultrasonography. The length of the hypoechoic core of the urethra was measured from the bladder neck to the distal part in the median sagittal plane. Age, parity, menopausal status and presence of SUI were recorded. Results: 144 patients were enrolled in the study. Overall, mean age was 45.2 ? 11.4 years, and median parity was 0 (range 0-5). Forty-one subjects (30.6%) were post-menopausal, while 47 (32.6%) reported SUI. Mean urethral length of the sample studied was 33.5 ? 3.4 mm, with a median of 33 mm. No differences were observed between subjects with and without SUI. The mean mid-urethral point was 16.8 ? 1.7 mm, with a median of 16.5 mm. Again, no differences were observed between subjects with and without SUI. Conclusion: Urethral length variability in the population evaluated in this study is limited, thus a standard vaginal incision for mid-urethral tape positioning may be used. Nevertheless, the analysis of mid-urethra points shows that the standard vaginal incision seems to increase the risk of incorrectly positioning the tape in some women. Either a pre-operative perineal ultrasound should be performed to identify the correct mid-urethra point for each patient or, alternatively, the vaginal incision should start between 10 and 15 mm from the external urethral meatus (precisely 12.5 mm)

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Cite the article

Tommaselli GA, Luffarelli P, Schiavi MC, Formisano C, Fabozzi A, Zullo MA. Variability of Urethral Length Evaluated Using Introital Ultrasonography and Its Value a Priori in Mid-Urethral Tape Positioning. Clin Surg. 2020; 5: 2982..