Reliability of a New Method for Assessing Tension and Configuration of Transobturator Suburethral Tapes Using Four-Dimensional Ultrasound

We conducted this study to evaluate the intra- and interobserver reliability of a new method in assessing the tension and configuration of transobturator suburethral tape (TOT) at different tape points using 4-dimensional (4D) ultrasound. We randomly recruited 20 women following TOT procedures. Postoperative ultrasound datasets acquired during rest, straining, and coughing were digitally stored and analyzed offline by 2 independent and blinded investigators. The assessed parameters included axial tape-urethral distance, axial urethral central echolucent area, axial tape angle, and coronal tape angle at 5 equidistant tape points. For most parameters, the intraclass correlation coefficient and 95% confidence interval for intra- and interobserver reliability was higher than 0.70. 4D ultrasound can provide a quantitative method that meets minimal standards for reliability coefficients in assessing the tension and configuration of TOT. The reliability of the current method could be further evaluated when a whole new ultrasound examination was performed.