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Effect of Intraoperative Ultrasonography on Preven ...
Effect of Intraoperative Ultrasonography on Prevention of Bladder Injury During TVT Procedure - Yoshifumi Ochi, MD
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A study conducted at two hospitals examined the use of ultrasound-guided hydrodissection in preventing bladder injury during tension-free vaginal tape (TVT) procedures for stress urinary incontinence (SUI). In Hospital A, where the hydrodissection was guided by ultrasound, there were no bladder injuries, but 4 bladder perforations occurred in Hospital B without ultrasound guidance. The study suggests that the use of intraoperative ultrasonography may prevent bladder injury during TVT procedures.<br /><br />TVT is considered the gold standard treatment for SUI due to its efficacy, safety, and low invasiveness. However, TVT has a higher risk of bladder injury compared to other procedures. Hydrodissection of the retropubic space is typically used to reduce bladder injury during TVT procedures. In this study, the researchers wanted to evaluate the effect of ultrasound-guided hydrodissection in preventing bladder injury during TVT procedures.<br /><br />The study included a retrospective cohort of 412 patients with SUI who underwent TVT procedures from January 2017 to December 2018. In Hospital A, ultrasonography-guided hydrodissection was performed during the TVT procedure, while normal hydrodissection without ultrasound guidance was performed in Hospital B. The results showed that there were no bladder injuries in Hospital A, but 4 bladder injuries occurred in Hospital B, along with other complications.<br /><br />The study concluded that the use of intraoperative ultrasonography may play a role in preventing bladder injury during TVT procedures. It is important to recognize bladder perforations during the initial procedure, as delayed recognition can lead to more morbidity. However, bladder perforation does not seem to affect long-term cure rates or have long-term complications.<br /><br />In summary, this study suggests that ultrasound-guided hydrodissection may be effective in preventing bladder injury during TVT procedures for SUI. The use of intraoperative ultrasonography can help identify bladder perforations and prevent complications. Further research and studies are needed to validate these findings and explore other potential benefits of ultrasound guidance in TVT procedures.
Keywords
study
ultrasound-guided hydrodissection
bladder injury
tension-free vaginal tape
stress urinary incontinence
intraoperative ultrasonography
retropubic space
gold standard treatment
SUI
bladder perforation
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