{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T13:19:21Z","timestamp":1709126361771},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2005,1,27]],"date-time":"2005-01-27T00:00:00Z","timestamp":1106784000000},"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":["BJOG"],"published-print":{"date-parts":[[2005,6]]},"abstract":"<jats:p><jats:bold>Objective\u2003<\/jats:bold> To determine the effect of intra\u2010operative monitoring of bladder neck elevation on cure rate and post\u2010operative complications in patients undergoing colposuspension.<\/jats:p><jats:p><jats:bold>Design\u2003<\/jats:bold> Prospective, observational study.<\/jats:p><jats:p><jats:bold>Setting\u2003<\/jats:bold> Urogynaecology units, university hospitals.<\/jats:p><jats:p><jats:bold>Population\u2003<\/jats:bold> Ninety women operated on for genuine stress urinary incontinence.<\/jats:p><jats:p><jats:bold>Methods\u2003<\/jats:bold> The topography of the bladder neck and proximal urethra was assessed with pre\u2010, intra\u2010 and post\u2010operative introital ultrasound. These measurements were repeated during follow up for up to 48 months after surgery. Burch colposuspension of the bladder neck was performed under intra\u2010operative introital ultrasound control, with reference to the patients' individual pre\u2010operative ultrasound, to achieve a vertical height correction of 1\u201310 mm.<\/jats:p><jats:p><jats:bold>Main outcome measures\u2003<\/jats:bold> Mid\u2010term surgical outcome and post\u2010operative complications.<\/jats:p><jats:p><jats:bold>Results\u2003<\/jats:bold> Ninety patients underwent colposuspension and 50 (56%) completed 48 months of follow up; 85 women (94%) were objectively continent at 12\u2010month follow up and 42 of 50 (82%) at 48\u2010month follow up. Surgical elevation of the bladder neck resulted in a median intra\u2010operative elevation of 9 mm (7 mm at 48 months). All post\u2010operative measurements demonstrated a significant decrease in linear dorsocaudal movement of the bladder neck during straining (<jats:italic>P<\/jats:italic> &lt; 0.001). Funnelling and hypermobility were still decreased 48 months after incontinence surgery (<jats:italic>P<\/jats:italic> &lt;0.001). Voiding difficulty and urgency were uncommon and associated with evidence of funnelling and hypermobility.<\/jats:p><jats:p><jats:bold>Conclusion\u2003<\/jats:bold> Intra\u2010operative introital ultrasound standardises Burch colposuspension and thus might help to avoid overelevation and associated post\u2010operative complications such as voiding difficulties and <jats:italic>de novo<\/jats:italic> urge incontinence without compromising the success of the operation.<\/jats:p>","DOI":"10.1111\/j.1471-0528.2005.00526.x","type":"journal-article","created":{"date-parts":[[2006,9,21]],"date-time":"2006-09-21T09:35:22Z","timestamp":1158831322000},"page":"791-796","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Intra\u2010operative introital ultrasound in Burch colposuspension reduces post\u2010operative 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