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• W2795912702 abstract "You have accessJournal of UrologyImaging/Radiology: Uroradiology IV1 Apr 2018MP63-18 PREOPERATIVE 3D TRANSLABIAL ULTRASOUND AIDS IN THE MANAGEMENT OF SYNTHETIC MID-URETHRAL SLING REMOVAL Nabeel Shakir, Connie Wang, Melissa Foreman, Melissa Foreman, Gaurav Khatri, and Philippe Zimmern Nabeel ShakirNabeel Shakir More articles by this author , Connie WangConnie Wang More articles by this author , Melissa ForemanMelissa Foreman More articles by this author , Melissa ForemanMelissa Foreman More articles by this author , Gaurav KhatriGaurav Khatri More articles by this author , and Philippe ZimmernPhilippe Zimmern More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2041AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In performing sub-urethral sling removal (SSR) - the preferred management at our institution for complications occurring long after synthetic mid-urethral sling (MUS) placement - accurate understanding of MUS location and morphology is critical as MUS may be scarred in and difficult to identify intraoperatively. We studied preoperative translabial ultrasound (TLUS) with 3D image reconstruction to determine impact on SSR planning. METHODS A prospectively maintained, IRB-approved database of non-neurogenic women who underwent SSR of a single MUS and had preoperative TLUS was queried. Demographics, presenting symptoms, and Urogenital Distress Inventory (UDI-6) questionnaire (total score range 0-100) were reviewed by a neutral investigator not involved in patient care. One experienced sonographer (MF) performed TLUS using a Philips iu22 system with an endovaginal probe placed at the introitus permitting 3D multiplanar image acquisition, and images were interpreted by a specialized radiologist. MUS depth at 6 o'clock, distance to bladder neck, and morphology (flat vs twisted/curled) were recorded. RESULTS From 2013-2017, 80 of 107 total patients met study criteria, presenting at a median 76 months post MUS placement with sling type retropubic (31), transobturator (47), and unknown (2). Median total UDI-6 score was 46 (IQR 33-58) and 67/80 (84%) of patients reported 3 or more symptoms. Median MUS depth was 3 mm (IQR 2-4) and distance to the bladder neck was 2 cm (1.5-2.3). MUS morphology was normal/flat in 30 patients, twisted/curled in 21 (Figure 1), and not intact in 29. Twisted MUS were closer to the urethral lumen (median depth 2.5 mm vs 3.4mm, p=0.009). There were no differences of MUS depth, distance to bladder neck or morphology between sling types (p=0.9, 0.6 and 0.7 respectively). TLUS aided in selecting the side of the sling furthest away from the urethral lumen, thereby avoiding potential urethral injury. CONCLUSIONS In this series, TLUS allowed for planning vaginal sub-urethral sling removal by providing precise information on MUS depth from the urethral lumen, position alongside the urethra, and morphology. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e848 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Nabeel Shakir More articles by this author Connie Wang More articles by this author Melissa Foreman More articles by this author Melissa Foreman More articles by this author Gaurav Khatri More articles by this author Philippe Zimmern More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2795912702 title "MP63-18 PREOPERATIVE 3D TRANSLABIAL ULTRASOUND AIDS IN THE MANAGEMENT OF SYNTHETIC MID-URETHRAL SLING REMOVAL" @default.
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