Can Stress Urinary Incontinence Be Predicted by Ultrasound?

Xiao, Ting; Chen, Ying; Gan, Yinbo; Xu, Jing; Huang, Weijun; Zhang, Xinling

doi:10.2214/ajr.18.20893

Cited by 17 publications

(26 citation statements)

References 30 publications

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“…The threshold value of BND was determined as 24mm (66.4% sensitivity, 84.5% specificity). The study indicated that transperineal ultrasonography was inadequate in predicting SUI but could reduce unnecessary urodynamics and treatment by identifying cases without SUI (9). Another study by Naranjo-Ortiz et al concluded that BND >25mm was in favor of urethral hypermobility (58% sensitivity, 60% specificity) (24).…”

Section: Accurate Evaluation Of the Stress Incontinence Is Of Great I...mentioning

confidence: 99%

“…Transperineal ultrasonography has also been introduced to evaluate the mobility of the bladder neck and proximal urethra. The majority of the prior studies concentrated on the degree of urethral angle (α), posterior urethrovesical angle (β), and bladder neck descent (BND), but there is a limited number of studies about rotation angles (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Moreover, to the best of our knowledge, there are no studies comparing the Q-tip test with transperineal ultrasonography and investigating Visual Analogue Scale (VAS) scores.…”

Section: Introductionmentioning

confidence: 99%

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The role of transperineal ultrasound in the evaluation of stress urinary incontinence cases

Turkoglu¹,

Coşkun

Arınkan

et al. 2022

Int. braz j urol.

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Purpose: To evaluate the use of transperineal ultrasonography while diagnosing stress urinary incontinence (SUI) by comparing the urethral angle (α), posterior urethrovesical angle (β), and bladder neck descent (BND) during rest and Valsalva maneuver in continent women and women with SUI. Materials and methods: This prospective observational study was conducted with 50 women with SUI and 50 continent women. Transperineal ultrasonography was performed at rest and during Valsalva maneuver. Q-tip test was performed. Results: During the Valsalva maneuver, both α and β angles were signifi cantly higher in women with SUI (p <0.001). The difference between Valsalva and rest measurements of α and β angles (R α, R β) were also signifi cantly higher in women with SUI (p <0.001). The cut-off point determined for the R α in the diagnosis of stress incontinence was 16° (80% sensitivity, 98% specifi city). A statistically signifi cant strong correlation was found between Q-tip test angle and R α value (p=0.000; r=0.890). Q-tip VAS pain scores were signifi cantly higher than ultrasonography VAS pain scores (p <0.001). In relation to the bladder neck descent comparison between the two groups showed that BND was signifi cantly higher in SUI group (p <0.001). The cut-off point determined for BND in the diagnosis of SUI was >11mm (90% sensitivity, 98% specifi city). Conclusion: Transperineal ultrasonography is a practical, reliable, non-invasive and comfortable method for evaluation of SUI. It has the advantage of dynamic evaluation during the Valsalva maneuver. Rotation angles and BND have high sensitivity and specifi city for detection of SUI. The change in α angle with Valsalva (Rα) can be used as an alternative to Q-tip test.

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Section: Accurate Evaluation Of the Stress Incontinence Is Of Great I...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The role of transperineal ultrasound in the evaluation of stress urinary incontinence cases

Turkoglu¹,

Coşkun

Arınkan

et al. 2022

Int. braz j urol.

View full text Add to dashboard Cite

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“…On Valsalva, the proximal urethra can usually be seen to rotate posteroinferiorly around the fulcrum of the symphysis pubis. Bladder neck position and mobility on Valsalva can be measured with high reliability 8,15,19,20,22 . Segmental urethral mobility can be determined with limited additional effort 12,14,15 …”

Section: Discussionmentioning

confidence: 99%

The Association of Hiatal Dimensions and Urethral Mobility With Stress Urinary Incontinence

Shi

Wen

Zhao

et al. 2021

J of Ultrasound Medicine

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Objectives To investigate the association of hiatal area (HA), bladder neck mobility, and urethral mobility during the cough stress test (CST) with stress urinary incontinence (SUI). Methods This was a prospective study of 110 continent and 190 incontinent women using transperineal ultrasound. HA, bladder neck mobility, and the mobility of six points along the urethra (Vectors 1–6) were measured. The cohort was randomly divided at a ratio of 2:1 into a training cohort and a validation cohort. The correlations of HA with bladder neck mobility, urethral mobility, and SUI were tested. The predictive model was yielded by fisher linear discriminant analysis and receiver operating characteristics to assess the parameters' ability to predict SUI. Results Valid data were collected from 177 incontinent women and 105 continent women. Significant differences were identified in HA, body mass index (BMI), funneling, bladder neck mobility, and Vectors 1–6 between them. HA was positively correlated to bladder neck mobility. In the training cohort, bladder neck position on Valsalva, Vectors 3, and BMI had the area under curves of 0.74, 0.69, and 0.66 (all P < 0.001); Funneling and Vector 3 had odds ratios of 18.96 and 3.65 (all P < 0.001), for predicting SUI. The predictive model incorporating funneling, Vectors 3, and BMI provided the best performance in predicting SUI in both cohorts. Conclusion The larger the HA was, the higher the bladder neck mobility. However, it was mid‐urethral mobility rather than bladder neck mobility that performed best at predicting SUI.

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“…11 The LH can increase with age 12 and a larger LH is associated with pelvic organ prolapse but not stress urinary incontinence. 13 Racial differences can influence the size of the LH. Previous studies have demonstrated that "black" nulliparous women have a significantly wider transverse diameter of the LH compared to age and body mass index matched white nulliparous women when assessed by translabial ultrasound.…”

Section: Hypothesis and Study Aimmentioning

confidence: 99%

“…The LH is described as the space between the inferior pubic rami and the puborectalis component of the levator ani muscle, measured at rest as the minimal hiatal dimensions in the mid‐sagittal plane using three‐dimensional (3D) translabial ultrasound 11 . The LH can increase with age 12 and a larger LH is associated with pelvic organ prolapse but not stress urinary incontinence 13 …”

Section: Hypothesis and Study Aimmentioning

confidence: 99%

Does size matter? Perineometer and digital examination of a model levator hiatus

Tailor

Bhide

Fernando

et al. 2020

Neurourology and Urodynamics

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Introduction Evaluation of the female pelvic floor muscles is commonly carried out with digital examination and assigning a modified Oxford scale score or vaginal manometry. Racial differences can influence the size of the levator hiatus (LH) with “black” or African nulliparous women having a significantly larger LH compared to Caucasian women. The aim of this study was to assess the impact of LH size on manometry readings of simulated pelvic floor muscle contractions (PFMCs) using a small and large model LH. Methods Small and large LH models were created using published data for size. Inflation of a pressure cuff placed circumferentially in the LH model represented a simulated PFMC. The models were examined in a supine position by three examiners and a perineometer twice each at varying simulated PFMC strength. Results Positive correlation was found between increasing simulated PFMC strength with a higher Oxford score following digital examination and manometry readings for both the small (rs = .87, rs = .98) and large (rs = .95, rs = .87) models. There was good to excellent inter and intraobserver correlation for digital assessment of both models. The manometry measurements showed a much larger incremental rise from baseline in the small model compared with the large model (P < .05). Conclusion This study demonstrates that perineometer readings are affected by natural variations in LH size and PFMC strength. Therefore improvement to pelvic floor strength cannot be interpreted and measurements cannot be compared with others unless the LH size is known or digital examination is carried out.

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Can Stress Urinary Incontinence Be Predicted by Ultrasound?

Cited by 17 publications

References 30 publications

The role of transperineal ultrasound in the evaluation of stress urinary incontinence cases

The role of transperineal ultrasound in the evaluation of stress urinary incontinence cases

The Association of Hiatal Dimensions and Urethral Mobility With Stress Urinary Incontinence

Does size matter? Perineometer and digital examination of a model levator hiatus

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