Role of three-dimensional ultrasound in assessment of women undergoing urethral bulking agent therapy

Abstract

Three-dimensional ultrasound imaging provides an objective means of assessing technical outcomes from urethral bulking agent therapy not available previously. The volume and configuration information obtained allows for rational therapeutic decision-making, particularly with regard to determining the need for re-injection and recognizing the failure of an adequate therapeutic trial.

Value of 3‐Dimensional Transrectal/ Transvaginal Sonography in Diagnosis of Distal Ureteral Calculi

“…Further advantages of 3D sonography relate to data storage capabilities; whereas 2D sonography typically requires interpretation at the time of scanning, 3D sonography allows for storage of a very complete set of data that can be examined in detail at a later date or even remotely. 28 The data in our prospective study show that endosonography with 3D image assessment is superior to IVU and abdominal sonography for diagnosing distal ureteral calculi. This technique is safe, easy to learn, and well accepted by most patients without the need for exposure to radiation or repeated exposure to radiation in the follow-up.…”

“…Several studies have shown low interobserver and intraobserver variability. 28,29 It is this ability to image small, irregular structures accurately and precisely that makes 3D sonography ideal for examinations of distal ureteral calculi. We could clearly show that 3D sonography had the best correlation in stone size measurement.…”

Comparison of the precision of transurethral endoscopic versus ultrasound‐guided application of injectables

“…Two‐dimensional US (2D‐US) has been the most widely applied technique for imaging of bulking agents, primarily because of its availability and significantly lower cost compared with cross‐sectional imaging using CT or MRI [5]. As with 3D‐US, most publications utilizing 2D‐US to assess urethral bulking agents have applied the technique after injection of collagen [6–8]. Most have tried to define imaging characteristics and the periurethral position/configuration in an attempt to determine the mechanism by which collagen treats SUI [8].…”

“…As with 3D‐US, most publications utilizing 2D‐US to assess urethral bulking agents have applied the technique after injection of collagen [6–8]. Most have tried to define imaging characteristics and the periurethral position/configuration in an attempt to determine the mechanism by which collagen treats SUI [8]. Fewer studies have used 2D‐US to compare the localization of injected collagen with the clinical outcome [9].…”

Imaging of Urethral Bulking Agents

“…Collagen-based bulking agents vary between hypoechoic, isoechoic, and hyperechoic. 5 The signal from a calciumbased agent will produce a hyperechoic structure on the image near the urethra 6 (Figure 2). Bulking deposits vary in size and shape.…”