Magnetic resonance imaging as an assessment tool following intervention with an AdVance XP suburethral sling for postprostatectomy urinary incontinence
| Autor: | Maria Barrios, Argimiro Collado Serra, José Cervera Deval, Ángel Alberich‐Bayarri, Isabel Martin, Jose Dominguez-Escrig, José Rubio-Briones, Paula Pelechano Gómez |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis Sling (implant) Urology medicine.medical_treatment 030232 urology & nephrology Urinary incontinence 03 medical and health sciences 0302 clinical medicine medicine Humans Prospective Studies Aged Aged 80 and over Prostatectomy Univariate analysis Suburethral Slings 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Prostate Magnetic resonance imaging Middle Aged Magnetic Resonance Imaging Surgery Urethra medicine.anatomical_structure Treatment Outcome Urinary Incontinence Neurology (clinical) medicine.symptom business Cohort study |
| Zdroj: | Neurourology and urodynamics. 38(6) |
| ISSN: | 1520-6777 |
| Popis: | Aims The aim of this study was to compare magnetic resonance imaging (MRI) parameters in patients with mild incontinence after radical prostatectomy, who had undergone treatment with a suburethral sling. The objective was to compare patients who had been successfully treated with unsuccessful patients. Methods This observational cohort study at a single institution evaluated consecutive patients treated with an AdVance XP sling. MRI was performed using a 1.5 Tesla system. Preoperative urodynamic assessment and flexible cystoscopy were performed. The qualitative analysis was based on sling indentation (complete vs incomplete). The quantitative analysis comprised the following three parameters: the sling-pubis distance, the thickness of the proximal urethral bulb, and the sling backward distance (SBD), defined as the distance between the prolongation of a line through the major axis of the pubis (the line-segment joining the vertices of the pubis) and the sling indentation. The primary outcome was pad count at 3 months; cure as zero pads. A logistic univariate regression model was employed to assess the potential predictors of successful outcomes. An adjusted multivariate logistic regression model using the significant univariate factors was developed. Results Of the 83 patients enrolled, the univariate analysis revealed a relationship between failure and adverse urodynamics and between success and sling indentation, thickness of the proximal bulb and SBD. Only the association with SBD persisted in the multivariate analysis. Conclusions MRI revealed a strong relationship between proper positioning of the sling (small SBD) and continence outcome. These data have important implications for a second surgery following initial sling failure. |
| Databáze: | OpenAIRE |
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