Epidemiological Features of the Bladder Neck Rest Position and Mobility

Abstract

The data concerning epidemiological determinants of the bladder neck (BN) mobility are scarce. The aim of the study was to determine epidemiological features and identify factors influencing BN position at rest and BN mobility in patients without pelvic organ prolapse (POP). Seven hundred and ninety-six patients that attended two outpatient clinics were enrolled in the study. Position and mobility of the BN were measured with the use of pelvic floor ultrasound. Demographic and functional factors that were hypothesized to influence BN mobility were assessed. Vaginal deliveries (VDs) and age ≥65 were associated with lower BN position at rest. Higher BN mobility was observed in women with stress urinary incontinence (SUI). In obese women, higher BN position and lower BN mobility was observed compared to non-obese women, and it was correlated with longer urethras in this group of patients. VDs and their number were associated with increased BN mobility, independently of body mass index (BMI). To conclude, obesity, VDs, and age are factors associated with changes in bladder neck position at rest and its mobility. Higher BMI correlates with restricted BN mobility, and, therefore, the incidence of SUI in obese patients is probably not connected to BN hypermobility.

Fractional carbon dioxide vaginal laser treatment of stress urinary incontinence: Remodeling of vaginal tissues and improving pelvic floor structures

“…A total of nine subjects underwent transperineal ultrasound scans both before treatment and at a 10–12‐month posttreatment follow‐up visit. Transperineal pelvic floor ultrasound scans were performed using a standard procedure 9 . The General Electric Voluson expert 730 type ultrasound system (GE Healthcare) with a 4–6 MHz curved array probe was used to visualize the median sagittal plane containing the urinary bladder, urethra, and pubic symphysis after being placed in the vaginal introitus at the level of the external urethral orifice 9 .…”

“…9 The General Electric Voluson expert 730 type ultrasound system (GE Healthcare) with a 4-6 MHz curved array probe was used to visualize the median sagittal plane containing the urinary bladder, urethra, and pubic symphysis after being placed in the vaginal introitus at the level of the external urethral orifice. 9 In a sagittal view of perineal ultrasonography, the linear distance between the urethral-bladder junction and the horizontal line through the margin of the symphysis pubis at rest and during the Valsalva maneuver were measured as the bladder neck position; the differences between these two bladder neck positions were defined as bladder neck mobility (in mm). 9 A total of six subjects underwent a pelvic floor MRI scan before treatment and at a follow-up visit 10-12months after treatment.…”

“…9 In a sagittal view of perineal ultrasonography, the linear distance between the urethral-bladder junction and the horizontal line through the margin of the symphysis pubis at rest and during the Valsalva maneuver were measured as the bladder neck position; the differences between these two bladder neck positions were defined as bladder neck mobility (in mm). 9 A total of six subjects underwent a pelvic floor MRI scan before treatment and at a follow-up visit 10-12months after treatment. During an MRI scan, the subject was instructed to remain in the supine position under the Valsalva maneuver; a T2-weighted single-shot fast spinecho sequence was used to obtain a series of sagittal images of the pelvis.…”

“…Among these factors, pregnancy and delivery mode are the most frequent; more than one‐third of pregnant women suffer episodes of or persistent SUI during pregnancy and even up to 6 years postpartum 4–8 . Mechanistically, anatomic disruptions causing urethral hypermobility and intrinsic sphincter deficiency are the primary pathophysiologic contributors to the etiology of SUI 2,9,10 . SUI significantly affects the quality of life of affected patients and requires treatment.…”

“…[4][5][6][7][8] Mechanistically, anatomic disruptions causing urethral hypermobility and intrinsic sphincter deficiency are the primary pathophysiologic contributors to the etiology of SUI. 2,9,10 SUI significantly affects the quality of life of affected patients and requires treatment. The conventional management of SUI includes surgical interventions and conservative treatments such as Kegel exercises.…”