Vaginal ultrasound studies before and after successful colposuspension and in continent controls.

OBJECTIVE: To study the position of the bladder neck in a group of women before and after a successful colposuspension and to compare them with a group of parous continent controls.

DESIGN: A single setting longitudinal descriptive study with case controls.

SETTING: Ikazia Hospital, Rotterdam, The Netherlands.

SUBJECTS: Twenty-five women with urodynamically proven genuine stress incontinence who underwent a Burch colposuspension and fifty controls who volunteered for the study for comparison.

MAIN OUTCOME MEASURES: The position of the bladder neck in relation to the symphysis pubis studied with vaginal ultrasound.

RESULTS: The cranio caudål displacement during straining was 11 mm in incontinent women, 5 mm after colposuspension and 7 mm in continent controls. In the anterior posterior axis this was 4 mm, 2 mm and 3 mm respectively. The colposuspension reduced the mobility of the bladder neck during straining from 32 degrees pre-operative to 10 degrees post operative. In the control group this was 16 degrees.

CONCLUSION: Colposuspension puts the bladder neck in a more cranial and anterior position than in normal parous controls. The rotational mobility of the bladder neck is significantly reduced by the operation. After the operation the bladder neck is less mobile than in a group of continent parous controls.