PDF(Sci-hub)
Abstract：
To present the characteristics of women attending a tertiary urogynecology pelvic floor scan clinic with mid-urethral sling (MUS) complications and examine the association between patient symptoms and findings on two-dimensional (2D) perineal and three-dimensional (3D) endovaginal ultrasound.
This was a cross-sectional study of all women with MUS complications referred to a specialist pelvic floor ultrasound clinic between October 2016 and October 2018. Detailed history was obtained regarding their symptoms and time of onset. All patients underwent 2D perineal and 3D endovaginal ultrasound assessment. The association between patient symptoms and ultrasound findings was evaluated using logistic regression analysis. Only symptomatic women with a single MUS, without other pelvic floor mesh, prior mesh excision or bulking agents, were included in the regression analysis.
A total of 311 women with a history of MUS surgery were seen during the study period. Vaginal and/or non-vaginal pain was reported by 80% of patients and this was the primary presenting complaint in 59% of the patients. One-third of the patients reported symptoms starting within 4 weeks after surgery. The data of 172 patients were included in the regression analysis. MUS position within the rhabdosphincter was significantly associated with voiding dysfunction (odds ratio (OR), 10.6 (95% CI, 2.2-50.9); P = 0.003). Voiding dysfunction was highest in those with C-shaped MUS both at rest and on Valsalva maneuver (OR, 3.2 (95% CI, 1.3-7.6); P < 0.001). MUS position in the distal third of the urethra was significantly associated with a higher rate of recurrent urinary tract infection (OR, 2.9 (95% CI, 1.3-6.3); P = 0.01).
Pelvic floor ultrasound can provide insight into the position and shape of the MUS, which could explain some patient symptoms and guide management or surgical planning. © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
This was a cross-sectional study of all women with MUS complications referred to a specialist pelvic floor ultrasound clinic between October 2016 and October 2018. Detailed history was obtained regarding their symptoms and time of onset. All patients underwent 2D perineal and 3D endovaginal ultrasound assessment. The association between patient symptoms and ultrasound findings was evaluated using logistic regression analysis. Only symptomatic women with a single MUS, without other pelvic floor mesh, prior mesh excision or bulking agents, were included in the regression analysis.
A total of 311 women with a history of MUS surgery were seen during the study period. Vaginal and/or non-vaginal pain was reported by 80% of patients and this was the primary presenting complaint in 59% of the patients. One-third of the patients reported symptoms starting within 4 weeks after surgery. The data of 172 patients were included in the regression analysis. MUS position within the rhabdosphincter was significantly associated with voiding dysfunction (odds ratio (OR), 10.6 (95% CI, 2.2-50.9); P = 0.003). Voiding dysfunction was highest in those with C-shaped MUS both at rest and on Valsalva maneuver (OR, 3.2 (95% CI, 1.3-7.6); P < 0.001). MUS position in the distal third of the urethra was significantly associated with a higher rate of recurrent urinary tract infection (OR, 2.9 (95% CI, 1.3-6.3); P = 0.01).
Pelvic floor ultrasound can provide insight into the position and shape of the MUS, which could explain some patient symptoms and guide management or surgical planning. © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
摘要：
介绍在三级泌尿外科妇科盆底扫描诊所就诊的女性中尿道悬吊（MUS）并发症的特征，并检查患者症状与二维（2D）会阴和三维（3D）阴道内超声检查结果之间的关系。
这是一项针对2016年10月至2018年10月期间转诊至专业盆底超声诊所的所有患有MUS并发症的女性的横断面研究。获得了有关其症状和发作时间的详细病史。所有患者均接受2D会阴和3D阴道超声评估。使用逻辑回归分析评估患者症状与超声检查结果之间的关联。只有单一MUS的有症状的女性，没有其他骨盆底网眼，先前的网状物切除或填充剂，纳入回归分析。
在研究期间，共有311名有MUS手术史的妇女被发现。80％的患者报告了阴道和/或非阴道疼痛，这是59％的患者的主要主诉。三分之一的患者报告症状在手术后4周内开始。将172例患者的数据纳入回归分析。横纹肌括约肌内的MUS位置与排尿功能障碍显著相关(比值比(OR),10.6（95%CI，2.2-50.9）；P=0.003）。在休息和Valsalva动作时，C形MUS的排尿功能障碍最高（OR，3.2（95%CI，1.3-7.6）；P<0.001）。尿道远端三分之一的MUS位置与复发性尿路感染的发生率显着相关（OR，2.9（95%CI，1.3-6.3）；P=0.01）。
盆底超声可以洞察MUS的位置和形状，这可以解释一些患者的症状，并指导治疗或手术计划。©2020作者由JohnWiley&SonsLtd代表国际妇产科超声学会出版的妇产科超声。
这是一项针对2016年10月至2018年10月期间转诊至专业盆底超声诊所的所有患有MUS并发症的女性的横断面研究。获得了有关其症状和发作时间的详细病史。所有患者均接受2D会阴和3D阴道超声评估。使用逻辑回归分析评估患者症状与超声检查结果之间的关联。只有单一MUS的有症状的女性，没有其他骨盆底网眼，先前的网状物切除或填充剂，纳入回归分析。
在研究期间，共有311名有MUS手术史的妇女被发现。80％的患者报告了阴道和/或非阴道疼痛，这是59％的患者的主要主诉。三分之一的患者报告症状在手术后4周内开始。将172例患者的数据纳入回归分析。横纹肌括约肌内的MUS位置与排尿功能障碍显著相关(比值比(OR),10.6（95%CI，2.2-50.9）；P=0.003）。在休息和Valsalva动作时，C形MUS的排尿功能障碍最高（OR，3.2（95%CI，1.3-7.6）；P<0.001）。尿道远端三分之一的MUS位置与复发性尿路感染的发生率显着相关（OR，2.9（95%CI，1.3-6.3）；P=0.01）。
盆底超声可以洞察MUS的位置和形状，这可以解释一些患者的症状，并指导治疗或手术计划。©2020作者由JohnWiley&SonsLtd代表国际妇产科超声学会出版的妇产科超声。
