Urethral mobility and Point Aa of the Pelvic Organ Prolapse Quantification (POP-Q) system before and after midurethral sling operation.

 The aim of the present study was to verify the usefulness of Point Aa as a substitute marker of the Q-tip angle and urethral mobility before and after midurethral sling operation for the treatment of stress urinary incontinence (SUI) in women.  In this study, 118 women presenting with SUI who underwent the tension-free vaginal tape obturator (TVTO) procedure were prospectively examined and followed-up for ≥6 months after operation. Spearman's correlation coefficient was used to assess the degree of correlation between Point Aa of the Pelvic Organ Prolapse Quantification system and Q-tip angles before and after midurethral sling surgery.  There were significant postoperative changes in Point Aa (from -0.4 ± 1.9 to -2.7 ± 0.6; P = .001) and Q-tip angle (from 58.7 ± 19.4 to 15.4 ± 17.5 degrees; P =.001) compared with preoperative values. A fair correlation between Point Aa position and straining Q-tip angle was found before (r = 0.45, P = .05) and after (r = 0.49, P = .04) the procedure, with no significant difference in values before and after the procedure (P = .62).  The results of the present study show fair correlation between the Point Aa position and straining Q-tip angle before and after midurethral sling surgery. Point Aa could be used as an indicator of urethral mobility after the TVTO procedure in women with SUI.

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