{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:30:24Z","timestamp":1747150224724,"version":"3.40.5"},"reference-count":22,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T00:00:00Z","timestamp":1659571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess the postsurgical sonographic parameters of a readjustable sling (RAS) according to urinary incontinence (UI) symptoms after surgery and compare this RAS sonographic pattern with mid\u2010urethral slings (MUS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Observational, prospective multicenter study, including women undergoing stress urinary incontinence (SUI) surgery with RAS (Remeex\u00ae). The primary outcome was the association between UI symptoms and sonographic parameters measured by two\u2010dimensional transperineal and high\u2010frequency endovaginal ultrasound. We measured static parameters (bladder neck funneling, RAS position, symmetry, distance to the urethral lumen), and the movement of the sling on Valsalva. UI symptoms were measured with the postsurgical <jats:italic>Incontinence Questionnaire\u2010Short Form<\/jats:italic> (ICIQ\u2010UI\u2010SF) questionnaire. We created two control groups including patients with transobturator\u2010MUS (TOT\u2010MUS) and retropubic\u2010MUS (RT\u2010MUS) to compare postsurgical sonographic parameters of RAS with MUS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 55 women with RAS included, the postoperative ICIQ\u2010UI\u2010SF scores were significantly higher in patients with bladder neck funneling (15.0 (3.9) vs 10.6 (6.7); <jats:italic>P<\/jats:italic>\u00a0=\u00a0.020) and in those with discordant movement of RAS on Valsalva (14.6 (5.7) vs 10.3 (6.7); <jats:italic>P<\/jats:italic>\u00a0=\u00a0.045). Compared with the 109 women with TOT\u2010MUS and the 55 with RT\u2010MUS, RAS was more often located in the proximal urethra and farther from the urethral lumen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Postsurgical pelvic floor ultrasound demonstrated that in women with complex SUI and hypomobile urethra who underwent RAS (Remeex\u00ae) surgery, the presence of bladder neck funneling and discordant movement on Valsalva correlate with the persistence of UI symptoms. In these women, RAS is more often located in the proximal urethra and farther from the urethral lumen at rest in comparison with MUS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.16076","type":"journal-article","created":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T07:09:53Z","timestamp":1659596993000},"page":"3069-3078","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Readjustable Sling in Women With Stress Urinary Incontinence and Hypomobile Urethra: Understanding the Mechanisms of Closure by Transperineal Ultrasound"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0455-6420","authenticated-orcid":false,"given":"Cristina","family":"Ros","sequence":"first","affiliation":[{"name":"Pelvic Floor Unit, ICGON Hospital Cl\u00ednic de Barcelona, University of Barcelona  Barcelona 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