Changes of Urethral Pressure Profilometry in Pubovaginal Sling and Modified Burch Colposuspension Procedures

Summary 

Objective

To evaluate the different effects on urethral pressure profilometry (UPP) in pubovaginal slingplasty (PVS) and modified Burch colposuspension (MBC) procedures.

Materials and Methods

This was a descriptive study of urodynamic parameters and urethral pressure profilometry. A total of 63 patients with successful anti-incontinence surgery were recruited for this study. Thirty-eight women had received MBC before 1998, to stabilize the bladder neck and the anterior vaginal wall. Twenty-five women had undergone autologous PVS to elevate the backstop effect on the proximal urethra between 1998 and 2000. All patients were followed-up for at least 24 months after surgery.

Results

The mean age of patients in the PVS group was 52.5 years (range, 32-70 years), and 45.5 years (range, 31-61 years) in the MBC group. Age and parity were not significantly different between the two groups. The pressure transmission ratio (PTR) of the urethra increased significantly in both groups during the postoperative evaluation. Patients who had the MBC procedure showed an increased PTR at quarter (Q) Q1, Q2, and Q3 of the urethra. However, in the PVS group, the PTR increased only at Q3. The urethral closure pressure elevated significantly after MBC, but there were no significant changes after PVS.

Conclusion

Our results indicate that different effects on UPP are evident in the PVS and MBC procedures. These two procedures should be considered in different anti-incontinence effect.

Key Words:  Burch colposuspension , pressure transmission ratio , pubovaginal sling , urethral pressure profilometry

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