Inverse correlation between urethral length and continence before and after native tissue pelvic floor reconstruction

Abstract Urethral length was evaluated retrospectively in patients with prolapse undergoing anterior native-tissue repair. Effects of age, prolapse stage, defect pattern, urodynamic and clinical stress test findings, and tension-free vaginal tape (TVT) surgery indication were analyzed using Mann–Whi...

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Autores principales:	A. R. Mothes, H. K. Mothes, A. Kather, A. Altendorf-Hofmann, M. P. Radosa, J. C. Radosa, I. B. Runnebaum
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4e6897c03b6a46678e79a708187c2495
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spelling	oai:doaj.org-article:4e6897c03b6a46678e79a708187c24952021-11-14T12:18:45ZInverse correlation between urethral length and continence before and after native tissue pelvic floor reconstruction10.1038/s41598-021-01565-z2045-2322https://doaj.org/article/4e6897c03b6a46678e79a708187c24952021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-01565-zhttps://doaj.org/toc/2045-2322Abstract Urethral length was evaluated retrospectively in patients with prolapse undergoing anterior native-tissue repair. Effects of age, prolapse stage, defect pattern, urodynamic and clinical stress test findings, and tension-free vaginal tape (TVT) surgery indication were analyzed using Mann–Whitney and Wilcoxon tests and linear and logistic regression. Of 394 patients, 61% had stage II/III and 39% had stage IV prolapse; 90% of defects were central (10% were lateral). Median pre- and postoperative urethral lengths were 14 and 22 mm (p < 0.01). Preoperative urethral length was greater with lateral defects [p < 0.01, B 6.38, 95% confidence interval (CI) 4.67–8.08] and increased stress incontinence risk (p < 0.01, odds ratio 1.07, 95% CI 1.03–1.12). Postoperative urethral length depended on prolapse stage (p < 0.01, B 1.61, 95% CI 0.85–2.38) and defect type (p = 0.02, B – 1.42, 95% CI – 2.65 to – 0.2). Postoperatively, TVT surgery was indicated in 5.1% of patients (median 9 months), who had longer urethras than those without this indication (p = 0.043). Native-tissue prolapse repair including Kelly plication increased urethral length, reflecting re-urethralization, particularly with central defects. The functional impact of urethral length in the context of connective tissue aging should be examined further.A. R. MothesH. K. MothesA. KatherA. Altendorf-HofmannM. P. RadosaJ. C. RadosaI. B. RunnebaumNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q A. R. Mothes H. K. Mothes A. Kather A. Altendorf-Hofmann M. P. Radosa J. C. Radosa I. B. Runnebaum Inverse correlation between urethral length and continence before and after native tissue pelvic floor reconstruction
description	Abstract Urethral length was evaluated retrospectively in patients with prolapse undergoing anterior native-tissue repair. Effects of age, prolapse stage, defect pattern, urodynamic and clinical stress test findings, and tension-free vaginal tape (TVT) surgery indication were analyzed using Mann–Whitney and Wilcoxon tests and linear and logistic regression. Of 394 patients, 61% had stage II/III and 39% had stage IV prolapse; 90% of defects were central (10% were lateral). Median pre- and postoperative urethral lengths were 14 and 22 mm (p < 0.01). Preoperative urethral length was greater with lateral defects [p < 0.01, B 6.38, 95% confidence interval (CI) 4.67–8.08] and increased stress incontinence risk (p < 0.01, odds ratio 1.07, 95% CI 1.03–1.12). Postoperative urethral length depended on prolapse stage (p < 0.01, B 1.61, 95% CI 0.85–2.38) and defect type (p = 0.02, B – 1.42, 95% CI – 2.65 to – 0.2). Postoperatively, TVT surgery was indicated in 5.1% of patients (median 9 months), who had longer urethras than those without this indication (p = 0.043). Native-tissue prolapse repair including Kelly plication increased urethral length, reflecting re-urethralization, particularly with central defects. The functional impact of urethral length in the context of connective tissue aging should be examined further.
format	article
author	A. R. Mothes H. K. Mothes A. Kather A. Altendorf-Hofmann M. P. Radosa J. C. Radosa I. B. Runnebaum
author_facet	A. R. Mothes H. K. Mothes A. Kather A. Altendorf-Hofmann M. P. Radosa J. C. Radosa I. B. Runnebaum
author_sort	A. R. Mothes
title	Inverse correlation between urethral length and continence before and after native tissue pelvic floor reconstruction
title_short	Inverse correlation between urethral length and continence before and after native tissue pelvic floor reconstruction
title_full	Inverse correlation between urethral length and continence before and after native tissue pelvic floor reconstruction
title_fullStr	Inverse correlation between urethral length and continence before and after native tissue pelvic floor reconstruction
title_full_unstemmed	Inverse correlation between urethral length and continence before and after native tissue pelvic floor reconstruction
title_sort	inverse correlation between urethral length and continence before and after native tissue pelvic floor reconstruction
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/4e6897c03b6a46678e79a708187c2495
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Inverse correlation between urethral length and continence before and after native tissue pelvic floor reconstruction

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