Bony pelvis dimensions in women with and without stress urinary incontinence

Abstract

AIMS To test the null hypothesis that bony pelvis dimensions are similar in women with and without stress urinary incontinence, both in the postpartum and midlife periods. METHODS Secondary analyses were performed of two case-control studies comparing women with stress urinary incontinence to asymptomatic controls. One study examined primiparas in the first 9–12 months postpartum; the other study involved middle-aged women. Stress urinary incontinence was confirmed by full-bladder stress test. All subjects underwent pelvic magnetic resonance imaging. The interspinous and intertuberous diameters, subpubic angle and sacrococcygeal joint-to-the inferior pubic point distance were measured from the images independently by two authors. RESULTS In the young cohorts, we compared primiparas with de novo postpartum stress urinary incontinence to both continent primiparas and nulliparas. Postpartum stress urinary incontinence is associated with a wider subpubic angle. There is also a trend towards wider interspinous and intertuberous diameters in the stress-incontinent primiparas as compared to the continent cohorts, although this did not reach statistical significance with our sample sizes. By contrast, no significant differences in bony pelvis dimensions were identified when comparing middle-aged women with stress urinary incontinence and their continent controls. CONCLUSIONS Bony pelvis dimensions are different in women with stress urinary incontinence than in matched continent controls. However, these differences are only identified in young primiparas in the postpartum period, not in middle-aged women.

Are bony pelvis dimensions associated with levator ani defects? A case–control study

“…Our study was not powered to detect smaller differences between measurements, but we would wonder whether such small differences would be clinically significant. Furthermore, the magnitude of the differences in pelvic dimensions we identified is similar to what has been shown in other studies, suggesting that this might be a widely reproducible finding [7, 26, 27]. We acknowledge that this study may be limited by spectrum bias as we only evaluated women at the extremes of LAD scores.…”

Dynamic MRI evaluation of urethral hypermobility post‐radical prostatectomy

“…MRI measurements were adapted from those previously identified and performed in women (reference) . Measurements were performed in the midsagital plane using T2‐weighted sequences both at rest and at maximum valsalva.…”

“…Measurements were obtained in reference to the sacrococcygeal to inferior pubis (SCIPP) line, which is a well‐established reference line that extends from the posterior surface of the pubis to the junction between the fifth sacral and first coccygeal bone (Fig. ) . In order to measure points on the urethra distal to the pubis, we simply extended the SCIPP line.…”

“…MRI measurements were adapted from those previously identified and performed in women (reference). 17,18 Measurements were performed in the midsagital plane using T2weighted sequences both at rest and at maximum valsalva. Measurements were obtained in reference to the sacrococcygeal to inferior pubis (SCIPP) line, which is a well-established reference line that extends from the posterior surface of the pubis to the junction between the fifth sacral and first coccygeal bone ( Fig.…”

“…1). [17][18][19][20] In order to measure points on the urethra distal to the pubis, we simply extended the SCIPP line. Three measurements were then taken in reference to the SCIPP line: the first measurement was taken as a perpendicular line from the SCIPP line to the bladder neck, shown as point B; the second measurement was taken as a perpendicular line from the area on the SCIPP line that corresponded to the inferior portion of the pubis to the urethra, point C; the final measurement was taken from the SCIPP line to the widest part of the bulbar urethra, point D. Figure 2 shows an example of the anatomic structures in a single subject at rest and with valsalva, in reference to the SCIPP line.…”