{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T10:21:49Z","timestamp":1792578109780,"version":"4.5.0"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2004,2,17]],"date-time":"2004-02-17T00:00:00Z","timestamp":1076976000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2004,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective of this prospective, observational study in patients after tension\u2010free vaginal tape (TVT<jats:sup>\u2122<\/jats:sup>) implantation was to describe the spatial relationship between suburethral sling implants, urethra and bony pelvis with the help of translabial two\u2010dimensional and three\u2010dimensional (3D) ultrasound.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 141 women were examined by translabial ultrasound, supine and after voiding. The TVT sling is highly echogenic and easily identified posterior to the urethra. Tape location was described in the mid\u2010sagittal plane relative to bladder neck and inferoposterior symphyseal margin, at rest and on Valsalva maneuver. In a subset of 83 women, 3D volume ultrasound was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cranial tape margin was situated on average 9.3 mm above and 16.5 mm posterior to the symphyseal margin (Valsalva: 3.9 mm below and 9.6 mm behind the symphysis); the average tape movement on Valsalva was 16 (range, 2\u201334.2) mm. The distance between tape and inferoposterior symphyseal margin narrowed highly significantly from 20.4 \u00b1 4.3 mm at rest to 12.9 \u00b1 3.9 mm on Valsalva (<jats:italic>P<\/jats:italic> &lt; 0.001). When a fitted line plot was placed through tape coordinates on an x\u2013y coordinate system, it became evident that tape movement occurs in an arc around the fulcrum of the posterior symphysis pubis. The result is an increasing reduction in the gap between tape and symphysis pubis (termed the \u2018iris effect\u2019), implying mechanical compression of the urethra.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The curative effect of the TVT on stress incontinence is likely to be due to mechanical compression of the urethra between implant and symphysis pubis. A large variation in tape location and movement explains its wide margin of clinical safety and efficacy. Copyright \u00a9 2004 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.985","type":"journal-article","created":{"date-parts":[[2004,3,12]],"date-time":"2004-03-12T08:04:39Z","timestamp":1079078679000},"page":"267-271","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":122,"title":["The \u2018iris effect\u2019: how two\u2010dimensional and three\u2010dimensional ultrasound can help us understand anti\u2010incontinence procedures"],"prefix":"10.1002","volume":"23","author":[{"given":"H. P.","family":"Dietz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. D.","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,2,17]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01902378"},{"key":"e_1_2_6_3_2","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1111\/j.1471-0528.1999.tb08272.x","article-title":"A three\u2010year follow\u2010up of tension\u2010free vaginal tape for surgical treatment of female stress urinary incontinence","volume":"106","author":"Ulmsten U","year":"1999","journal-title":"Br J Obstet Gynaecol"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s192-002-8346-5"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-410X.2002.02725.x"},{"key":"e_1_2_6_6_2","first-page":"S1","article-title":"Contribution of modeling to understanding of the mode of action of sub\u2010urethra tape procedure for cure of female stress incontinence","volume":"13","author":"Valentini FA","year":"2002","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/nau.10092"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.268"},{"key":"e_1_2_6_9_2","article-title":"How important is TVT location?","author":"Dietz HP","year":"2004","journal-title":"Acta Obstet Gynecol Scand"},{"key":"e_1_2_6_10_2","first-page":"393","article-title":"How does the TVT achieve continence?","volume":"19","author":"Dietz HP","year":"2000","journal-title":"Neurourol Urodyn"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-1999-14226"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2001.800705.x"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.100"},{"issue":"1","key":"e_1_2_6_14_2","first-page":"S87","article-title":"Pelvic anatomy changes after TVT procedure assessed by MRI","volume":"10","author":"Halaska M","year":"1999","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1995.tb09068.x"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001703-200010000-00013"},{"key":"e_1_2_6_17_2","first-page":"190","volume-title":"International Continence Society 2002 Conference Proceedings","author":"Fritel X"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.985","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.985","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.985","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,8]],"date-time":"2023-10-08T15:34:45Z","timestamp":1696779285000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.985"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,2,17]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2004,3]]}},"alternative-id":["10.1002\/uog.985"],"URL":"https:\/\/doi.org\/10.1002\/uog.985","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,2,17]]},"assertion":[{"value":"2003-12-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2004-02-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}