Clinical significance of anatomical urethral length on stress urinary incontinence women

Shin, Yu Seob; You, Jae Hyung; On, Ji Won; Kim, Myung Ki

doi:10.2147/ijwh.s161672

Cited by 5 publications

(6 citation statements)

References 12 publications

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“…Not only the anatomy, but also the tissue quality, appears to contribute to pelvic floor dysfunction. Despite other groups reported longer urethras to be correlated with better continence 16,17,23 , our study data do not support this findings. There are a few studies available reporting longer urethras rather being associated with incontinence 36,37 .…”

Section: Discussioncontrasting

confidence: 99%

“…Urethral funneling has been shown to be anatomically associated with shortened urethras as well as with urinary incontinence in up to 97% 17 . Other groups found a positive correlation between anatomical urethral length and urethral closure 23 . Therefore, we hypothesized shorter urethras to be associated with ISD and preoperative incontinence symptoms, and that longer post-repair urethras would be associated with better postoperative continence.…”

mentioning

confidence: 88%

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Inverse correlation between urethral length and continence before and after native tissue pelvic floor reconstruction

Mothes

Kather

et al. 2021

Sci Rep

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Urethral length was evaluated retrospectively in patients with prolapse undergoing anterior native-tissue repair. Effects of age, prolapse stage, defect pattern, urodynamic and clinical stress test findings, and tension-free vaginal tape (TVT) surgery indication were analyzed using Mann–Whitney and Wilcoxon tests and linear and logistic regression. Of 394 patients, 61% had stage II/III and 39% had stage IV prolapse; 90% of defects were central (10% were lateral). Median pre- and postoperative urethral lengths were 14 and 22 mm (p < 0.01). Preoperative urethral length was greater with lateral defects [p < 0.01, B 6.38, 95% confidence interval (CI) 4.67–8.08] and increased stress incontinence risk (p < 0.01, odds ratio 1.07, 95% CI 1.03–1.12). Postoperative urethral length depended on prolapse stage (p < 0.01, B 1.61, 95% CI 0.85–2.38) and defect type (p = 0.02, B – 1.42, 95% CI – 2.65 to – 0.2). Postoperatively, TVT surgery was indicated in 5.1% of patients (median 9 months), who had longer urethras than those without this indication (p = 0.043). Native-tissue prolapse repair including Kelly plication increased urethral length, reflecting re-urethralization, particularly with central defects. The functional impact of urethral length in the context of connective tissue aging should be examined further.

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Section: Discussioncontrasting

confidence: 99%

mentioning

confidence: 88%

Inverse correlation between urethral length and continence before and after native tissue pelvic floor reconstruction

Mothes

Kather

et al. 2021

Sci Rep

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“…We found that FUL shortened significantly in women with higher stages of AVWP. Our finding is similar to the results of Shin et al 20 However, only FUL at rest significantly decreased in different groups in our study. FUL during stress did not have the same result.…”

Section: Discussionsupporting

confidence: 93%

“…FUL is an important factor which may lead to SUI, urethral hypermobility, and intrinsic sphincter deficiency when urethral dysfunction transpires 20,21 . FUL in women with SUI was apparently shorter than in women without SUI 22 .…”

Section: Discussionmentioning

confidence: 94%

Correlations between severity of anterior vaginal wall prolapse and parameters of urethral pressure profile

Chang

Chen

2020

LUTS

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Objective Previous studies have shown that anterior vaginal wall prolapse (AVWP) results in reduction of pressure in the proximal urethra. However, the effect of severity of AVWP on urethral pressure is controversial. This study aimed to evaluate parameters of the urethral pressure profile in different stages of AVWP. Materials and methods From 2016 to 2017, 286 consecutive patients with urogynecologic complaints who were referred to our urodynamic unit were enrolled in this study to analyze their urethral pressure profiles. Stages of AVWP were regrouped into three groups ranging from mild to severe stages (groups 1‐3). Maximal urethral pressure, urethral closure pressure, functional urethral length, length of continence zone, as well as area of continence zone were compared among these three groups. Results Distribution of age, parity, and menopausal women were significantly different among these three groups. Maximal urethral pressure (pressures for groups 1, 2, and 3 were 74.6∼75.9cmH2O, 69.7∼73.4cmH2O, and 58.3∼60.5cmH2O, respectively; all P<.05) and stress urethral closure pressure (pressures for groups 1, 2, and 3 were 69.3cmH2O, 62.3cmH2O, and 52.2cmH2O, respectively; all P<.05) gradually and significantly decreased, consistent with the severity of AVWP. However, the attenuated maximal urethral pressure and stress urethral closure pressure in accordance with severity did not show any significant difference after controlling for age, body mass index, parity, menopause, and stress urinary incontinence symptoms. Conclusion Our results showed that AVWP significantly attenuated urethral pressure. However, patient age, menopausal status, and number of parities seem to be more influential in compromising urethral function than just AVWP alone.

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“…Effects of perineal anatomy characteristics on SUI is one of the hottest topic in urogynecology. Shin et al investigated the relation between urethral length and SUI, and authors claimed that patients with SUI had a significantly shorter urethral length than in patients without SUI [4]. In another study, Athanasopoulos and colleagues evaluated the correlation between perineal measurement parameters (perineal body length, fourchette-coccyx distance, anal-coccyx length) and SUI in women; however, authors found perineal measurement parameters had no effect on SUI [5].…”

Section: Introductionmentioning

confidence: 99%

Effect of anogenital distance on stress urinary incontinence

Ekmez

Ekmez²

2021

Afr J Urol

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Background To clarify the effect of anogenital distance (AGD) on stress urinary incontinence (SUI) in female patients. Methods Charts of patients who admitted to urogynecology polyclinic between December 2020 and February 2021 were analyzed retrospectively. The AGD parameters including anogenital distance from the anus to the clitoris (AGDAC), anogenital distance from the anus to the fourchette (AGDAF) and genital hiatus (GH) were measured. To identify effect of ADG parameters on SUI, patients were divided into the two subgroups (patients with SUI and without SUI). Demographic characteristics of patients and perineal anatomy measurement were compared between groups. Results Totally, 256 female patients met study inclusion criteria. In comparison of patients with and without SUI, demonstrated that age, weight, height, and BMI were similar between groups (p = 0.200, p = 0.455, p = 0.131, and p = 0.215, respectively). The AGDAF was measured 22.6 mm in patients with SUI and 25.5 mm in patients without SUI (p = 0.014). In contrast, AGDAC was significantly longer in patients with SUI (81.1 mm vs. 72.2 mm, p = 0.001). Also, GH was significantly longer in patients with SUI (p = 0.016). Multivariate logistic regression analysis revealed that one mm increment in AGDAC and GH, is associated with 1.108- and 1.038-fold time of SUI development risk, respectively (p = 0.001 and p = 0.004). In contrast, decrease in AGDAF is resulted with significantly higher risk for SUI (p = 0.001). Conclusion The present study demonstrated that shorter AGDAF, and longer AGDAC and GH were resulted with significantly higher incidence of SUI. Considering the ease and non-invasiveness of anogenital distance measurement, an important implication of the results of current study is that it is a measurement that can be easily performed during routine gynecological and obstetric examinations as a suitable tool for use in the prediction of women who will develop stress incontinence in the future.

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Clinical significance of anatomical urethral length on stress urinary incontinence women

Cited by 5 publications

References 12 publications

Inverse correlation between urethral length and continence before and after native tissue pelvic floor reconstruction

Inverse correlation between urethral length and continence before and after native tissue pelvic floor reconstruction

Correlations between severity of anterior vaginal wall prolapse and parameters of urethral pressure profile

Effect of anogenital distance on stress urinary incontinence

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