Application of Transrectal
Sonography in the Diagnosis
and Treatment of Female Stress
Urinary Incontinence

Kuo, Hann‐Chorng; Chang, Shih-Chung; Hsu, Tsi

doi:10.1159/000475347

Cited by 18 publications

(11 citation statements)

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“…17,18 The width of the sling was measured in the sagittal section of the midline of the urethral axis. The distance between the sling and the bladder neck was measured along the urethral axis in the sagittal section.…”

Section: Methodsmentioning

confidence: 99%

Sonographic evaluation of anatomic results after the pubovaginal sling procedure for stress urinary incontinence.

Kuo

2001

J of Ultrasound Medicine

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Objective. To investigate the anatomic changes after the pubovaginal sling procedure in women with stress urinary incontinence by transrectal sonography. Methods. This study enrolled 56 women with varying types of stress urinary incontinence who were treated with the pubovaginal sling procedure using self-fashioned polypropylene mesh. The suburethral sling was fixed without tension and was placed at the position between the bladder neck and the proximal urethra. The patients were investigated preoperatively and postoperatively by transrectal sonography of the bladder and urethra. Results. At a median follow-up of 24 months (range, 6-39 months), 48 patients (85.7%) were cured, 6 (10.7%) had improved, and 2 (3.6%) had treatment failures. Transrectal sonography revealed a wellsuspended bladder neck and proximal urethra in all patients who were cured. As measured by changes of the axis of the pubovesical ligament, the position of the bladder neck was elevated by a mean of 29.6 ± 21.5°in the resting condition and 47.4 ± 27.7°in the straining condition. An incompetent bladder neck and proximal urethra were noted in 8 patients who had stress urinary incontinence after surgery. The incidence of opening of the bladder neck was 84.6% in 13 patients with de novo urgency or urge incontinence, whereas only 2 (4.7%) of 43 patients who did not have postoperative urgency had opening of the neck (P = .000). Conclusion. Transrectal sonography provides useful information about anatomic changes after the pubovaginal sling procedure. Bladder neck incompetence after surgery was closely related to postoperative urgency or urge incontinence.

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Section: Methodsmentioning

confidence: 99%

Sonographic evaluation of anatomic results after the pubovaginal sling procedure for stress urinary incontinence.

Kuo

2001

J of Ultrasound Medicine

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“…Kuo et al [54] measured the BS length and the rotational angle. The angle increases with straining as the severity of SUI increases.…”

Section: Transrectal Ultrasonographymentioning

confidence: 99%

Ultrasonography in stress urinary incontinence

Demirci

Fine

1996

Int Urogynecol J

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Evaluation of the urethrovesical junction in stress urinary incontinence is essential. For this reason the Q-tip test, a clinical test with debatable specificity; lateral cystourethrography, a conventional method; and videourethrocystography, a sophisticated method, have been in use. Because ultrasonography is inexpensive, reliable, easy to apply and free of any contrast material and X-ray exposure, it has practically replaced all the former methods in the evaluation of the urethrovesical junction in stress urinary incontinence patients within the last decade.

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“…7). Kuo et al [1] classified SUI by mobility and funnelling; the wider the funnelling, the more severe the UI. If the hypermobility disappears, it means that the urethra has become a rigid structure unable to compensate for the slightest increase in abdominal pressure.…”

Section: Discussionmentioning

confidence: 99%

Introital ultrasonography: a comparison of women with stress incontinence due to urethral hypermobility and continent women

et al. 2006

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at rest and on straining. Several distances were measured to determine if any provided an objective distinction between continent and incontinent women. RESULTSAmong all the IUS variables assessed, sliding (calculated as the difference between the distance urethra-bladder neck, U-BN, at rest and under stress) was the best for distinguishing continent and incontinent women. The receiver operating characteristic curves showed that with a threshold of 8 mm, sliding had a sensitivity of 92% and a specificity of 79.6% for detecting SUI due to UH. The distances symphysis-urethra (S-U) and U-BN at rest could also discriminate, but with lower significance. CONCLUSIONSIUS is an important tool for diagnosing SUI; there are three independent variables, one dynamic (sliding) and two static (distances S-U and U-BN), that can be used to distinguish between continent women and those with SUI due to UH. Sliding is the most reliable, as it has the highest sensitivity and specificity. We think that the simplicity, low financial cost and reliability of IUS could allow it to be a routine procedure for physicians working in incontinence units. KEYWORDSstress urinary incontinence, sliding, urethral hypermobility, introital ultrasonography OBJECTIVETo determine if there is a variable on introital ultrasonography (IUS) that can be used to distinguish between women with stress urinary incontinence (SUI) due to urethral hypermobility (UH) and continent women. PATIENTS AND METHODSThis single-centre, prospective, blind, cohort, observational study comprised 383 women (245 continent and 138 incontinent) who were all appropriately informed volunteers selected according to the inclusion criteria. IUS with a convex probe was performed on all women; the measurement plane was standardized and coordinates were obtained

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Application of Transrectal Sonography in the Diagnosis and Treatment of Female Stress Urinary Incontinence

Cited by 18 publications

References 0 publications

Sonographic evaluation of anatomic results after the pubovaginal sling procedure for stress urinary incontinence.

Sonographic evaluation of anatomic results after the pubovaginal sling procedure for stress urinary incontinence.

Ultrasonography in stress urinary incontinence

Introital ultrasonography: a comparison of women with stress incontinence due to urethral hypermobility and continent women

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