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Using clinical estimate or catheter measurement of urethral mid-point result in similar retropubic mid-urethral sling position: a randomized trial

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Abstract

Introduction and hypothesis

The objective was to determine whether standardized, intraoperative urethral measurement improves retropubic mid-urethral sling (RPMUS) positioning and if the intraoperative position remains stable at 2 weeks postoperatively.

Methods

Participants undergoing a RPMUS were randomized to mid-urethral placement as per usual surgical care (no Foley catheter measurement, no-FCM) vs urethral mid-point Foley catheter measurement (FCM). The primary outcomes were RPMUS location as determined by 2D and 3D ultrasound 2 weeks postoperatively (as percentage from urethral meatus − relative to the urethral length) and intraoperatively following the RPMUS placement.

Results

Forty-four women enrolled, underwent RPMUS, and provided baseline data and intraoperative ultrasound measurements; of these, 36 (82%) had interpretable intraoperative and postoperative ultrasound measurements. Demographic data were similar in the two groups. The mean RPMUS mid-point was 57 % and 55 % in measured and controls (p = 0.685); this same measurement was relatively unchanged at 2 weeks postoperatively at 57% and 54% respectively (p = 0.538). Very much and much improvement was reported on the PGI-I by 84% and 85% of participants in the FCM and no-FCM groups respectively.

Conclusions

Intraoperative RPMUS position at 2 weeks after surgery is similar to the intraoperative position. Compared with usual surgical care, intraoperative measurement of urethral mid-point with a Foley catheter did not affect RPMUS sling position.

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Author information

Author notes

  1. H. C. Barnes

    Present address: University of Cincinnati College of Medicine, 231 Albert Sabin Way, Medical Sciences Building Room 4505, Cincinnati, OH, 45267-0526, USA

  2. A. Akl

    Present address: AZ Urogynecology & Pelvic Health Center, 9700 N. 91st Street, Suite A-103, Scottsdale, AZ, 85258, USA

  3. S. K. Taege

    Present address: Mount Carmel Urogynecology-Mount Carmel Medical Group, 495 Cooper Road Suite 320, Westerville, OH, 43081, USA

Authors and Affiliations

  1. Division of Female Pelvic Medicine and Reconstructive Surgery, Departments of Obstetrics/Gynecology and Urology, Loyola University Chicago Stritch School of Medicine, Loyola University Medical Center, 2160 S. 1st Avenue, Maywood, IL, 60153, USA

    H. C. Barnes, A. Akl, S. K. Taege & E. R. Mueller

  2. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Rush University Medical Center, Chicago, IL, USA

    C. Brincat

  3. Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA

    L. Brubaker

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  1. H. C. Barnes
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Contributions

H.C. Barnes: data analysis, manuscript writing; A. Akl: project development, data collection, data analysis, manuscript writing; S.T. Taege: data collection, data analysis, manuscript writing; C. Brincat: project development, data analysis, manuscript editing; L. Brubaker: project development, data analysis, manuscript editing; E.R. Mueller: project development, data collection, data analysis, manuscript writing.

Corresponding author

Correspondence to E. R. Mueller.

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Financial disclaimers/conflicts of interest

L. Brubaker: editorial stipends from Female Pelvic Medicine and Reconstructive Surgery, UpToDate and JAMA, research funding from the NIH; E.R. Mueller: honoraria from UpToDate, research funding from NIH, legal consultation Ethicon/Butler Snow. The remaining authors report no disclosures.

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Barnes, H.C., Akl, A., Taege, S.K. et al. Using clinical estimate or catheter measurement of urethral mid-point result in similar retropubic mid-urethral sling position: a randomized trial. Int Urogynecol J 33, 3555–3561 (2022). https://doi.org/10.1007/s00192-022-05167-9

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