Clinical significance of changes in related parameters of pelvic floor ultrasound before and after TVT operation
Objective:To compare the changes of pelvic floor ultrasound parameters before and after TVT in patients with moderate to severe stress urinary incontinence(SUI)and analyze the results.Methods:Forty-two fe-male patients with moderate to severe SUI who visited the female urology clinic and were admitted for surgery in Shaanxi Provincial People's Hospital from November 2019 to March 2022 were included.The patients completed the relevant examinations before admission and planned to undergo TVT under general anesthesia.Before the sur-gery,transperineal pelvic floor ultrasound examination was performed at rest and during Valsalva maneuver,and the urethral inclination angle and bladder posterior angle were collected.After the surgery,the urethral inclination angle,bladder neck mobility,bladder posterior angle and urethral rotation angle at rest and during Valsalva ma-neuver were recorded.Results:All 42 patients completed TVT.The clinical symptoms of patients with moderate to severe SUI improved after TVT.Pelvic floor ultrasound showed that the bladder posterior angle of the patients was significantly reduced after the surgery([124.20±4.50]° vs[110.51±3.20]°,P=0.030)at rest,and there was no significant change in the urethral inclination angle([23.60±2.97]° vs[23.86±1.89]°,P=0.930).Dur-ing Valsalva maneuver,the urethral inclination angle([45.20±3.58]° vs[28.86±2.88]°,P=0.001),bladder posterior angle([159.97±5.96]° vs[134.49±5.76]°,P=0.003),bladder neck mobility([2.77±0.93]cm vs[1.76±0.13]cm,P=0.001),and urethral rotation angle([67.22±4.44]° vs[40.54±4.68]°,P=0.001)of the patients were significantly reduced after the surgery.Conclusion:Pelvic floor ultrasound can help select pa-tients who are candidates for TVT surgery,predict surgical outcomes and risk of complications,and monitor the status and function of the postoperative sling.Changes in pelvic floor ultrasound indicators can reflect the impact of TVT surgery on pelvic floor anatomy and function.
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