Změny vezikalizace uretry a močového měchýře po TVT operaci

Changes in Vesicalization of Urethra and Bladder after TVT Operation

Objective:
The aim of our study was to asses the changes of the funnelling and the thickness of the urinary bladder after successful TVT procedure.

Design:
Prospective pilot study.

Setting:
Obstet. Gynecol Department, General Teaching hospital, Ist Medical Faculty, Charles University, Prague. EuroMISE Centre of the Charles University and Academy of Sciences, Prague, Czech Republic.

Methods:
In the prospective study were evaluated 90 women after successful TVT procedure (in the study was primarily included 101 women with proven stress urinary incontinence). Ultrasound scan was performed before surgery and 3–6 months after operation as a part of the complex urogynecological examination. Together with urethral mobility was assessed the funnelling at rest and at maximal Valsalva (the width and depth of visible opening of the proximal urethra). Thickness of the bladder wall was measured after emptying of the urinary bladder at three points (anterior, trigone and dome). The changes induced by the surgery were assessed. For the statistical evaluation t-test and Wilcoxone test were used.

Results:
The operation did not influence the proximal urethra at rest and significantly decreased funnelling during maximal Valsalva (width and depth). After the surgery there was a slight increase in the thickness of the bladder wall (anterior and trigone by 0.4 mm).

Conclusions:
The action of the tape is more complex that only the compression of the urethra. The tape influenced the proximal urethra at maximal Valsalva, significantly decreased the funnelling.

Key words:
introital ultrasound, stress urinary incontinence, TVT, bladder neck, funnelling