Stress urinary incontinence: usefulness of perineal ultrasound

Perineal ultrasound provides the most sensitive assessment of the degree of urethral mobility by measuring the pubo-urethral distance and angle. To evaluate whether these indices may be determinants of success in prosthetic surgery for stress urinary incontinence, we conducted a retrospective study of patients treated with tension-free vaginal tape-obturator (TVT-O) surgery and assessed, by measuring the pubo-urethral distance and angle after TVT-O, whether there was any quantitative difference between the mean values measured in the group of cured patients and uncured patients.

We selected 51 patients who underwent TVT-O and evaluated the failure rate by means of urogynaecological assessment. We also measured, using perineal ultrasound, the mean values of the pubo-urethral distance and angle between the two groups of patients.

We recorded a difference in the average pubo-urethral distance of 3 mm ± 1.2 at rest and 2.7 mm ± 1.2 under stress and a difference in the average pubo-urethral angle of 13° ± 6.3° at rest and 8° ± 6.3° under stress between the two groups.

We obtained higher mean values of pubo-urethral distance and angle in uncured patients compared to those found in the group of cured patients.