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Urethral configuration and mobility during urine leaking described using real-time transperineal ultrasonography

Ultrasonography 2022년 41권 1호 p.171 ~ 176
Zhao Baihua, Wen Lieming, Liu Dan, Huang Shanya,
소속 상세정보
 ( Zhao Baihua ) - Central South University Second Xiangya Hospital Department of Ultrasound Diagnosis
 ( Wen Lieming ) - Central South University Second Xiangya Hospital Department of Ultrasound Diagnosis
 ( Liu Dan ) - Central South University Second Xiangya Hospital Department of Ultrasound Diagnosis
 ( Huang Shanya ) - Central South University Second Xiangya Hospital Department of Ultrasound Diagnosis

Abstract


Purpose: The aim of this study was to explore differences in the bladder neck configuration and segmental urethral mobility during the cough stress test (CST) in the supine and standing positions between women with and without stress urinary incontinence (SUI).

Methods: This prospective study included 100 control women and 100 incontinent women who had a CST with transperineal ultrasonography. The bladder neck configuration and urethral mobility were described in terms of urethral funneling, bladder neck descent (BND), retrovesical angle (RVA), urethral rotation angle, and urethral mobility at six points along the urethra (vectors 1 to 6). The two groups’ ultrasound findings in the two positions were compared.

Results: Valid data were collected from 78 control women and 90 women with SUI. Significant differences were found in age and body mass index between the two groups (P<0.01). Urethral funneling was found in 33 women (36.7%) with SUI and five continent women (6.4%) and altered little in the standing position. In the standing position, the mean RVA significantly increased (160° to 179°, P<0.001) in the SUI group; The mean vector of points 1 to 6 significantly increased in the control group (all P<0.001). The RVA, BND, and vectors 1 to 4 were significantly greater (all P≤0.01) in women with SUI than without, in both positions.

Conclusion: Urethral funneling was an intrinsic anatomical characteristic relative to SUI. Weak upper- and mid-urethral support and an unstable connection between the trigone and proximal urethra were the anatomical signs of SUI.

키워드

Pelvic floor ultrasound; Stress urinary incontinence; Cough stress test; Urethral hypermobility

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