The analysis of repeatability and reproducibility of bladder neck mobility measurements obtained during pelvic floor sonography performed introitally with 2D transvaginal probe

Abstract

Objectives: The aim of the study was the evaluation of repeatability and reproducibility of chosen urethral neck mobility measurements obtained during introital pelvic floor sonography performed with a 2D transvaginal probe. Material and methods:In order to assess the repeatability and reproducibility, independent measurements on the ultrasound image were taken by two specialists on 92 female patients at rest and at strain (Valsalva maneuver). 2D ultrasound examination was performed introitally with a transvaginal probe (PFS-TV). The location of the urethral internal orifice was defined with coordinates of two points. Point CI marks the urethral anterior edge visualized on ultrasound as closer to the pubic symphysis. Point CII marks the posterior edge visualized more peripherally from pubic symphysis.Results: Repeatability and reproducibility measurements of point CI location and mobility were good and very good (0.6710-0.9961), while of point CII -were medium, good and very good (0.5738-0.9944). Point CI was clearly visible in all cases. It was not possible to accurately mark point CII in 4.3-17.4% of cases. Conclusions:The possibility to visualize point CI in every single case with very good and good repeatability and reproducibility of measurements of this point's location and mobility allows the usage of CI point as a universal reference point for evaluation of bladder neck mobility and position during PFS-TV in the clinical practice and for research purposes.

The role of TVT position in relation to the pubic symphysis in eliminating the symptoms of stress urinary incontinence and urethral funneling

“…Standardized PFS-TV was performed using Philips EnVisorC, Hitachi EUB-525 and BK Pro Focus ultrasound systems, a 6.5 MHz transvaginal probe, 160° beam angle, as in accordance with a technique developed by Kociszewski (7,5,10,11) , in a patient in a semi-sitting position with a normalized bladder volume of 250–300 mL, which was calculated from 3 bladder dimensions: transverse, anteroposterior and superior-inferior.…”

“…In addition to standard diagnostic methods, such as cough stress test, pad test, voiding diary or urodynamic testing, ultrasonography is also likely to play an important role in the diagnosis and assessment of patients with SUI (2) . Pelvic floor ultrasound performed with transvaginal probe (PFS-TV) shows excellent and good repeatability of the obtained results (4,7,8) . In addition to sonographic evaluation of urethral and bladder neck mobility, as well as postoperative sonographic localization of the tape, visualization of urethral funneling, which, according to different authors, may overlap with SUI in 18.6% to 100% women, is also possible (2,9) .…”

Urogynecology Section of the Polish Society of Gynecologists and Obstetricians guidelines on the management of stress urinary incontinence in women

“…Some studies indicated the possibility of improved outcomes of SUI therapy after MUS surgery if the procedure is individualized using pelvic floor sonography (PFS). The choice of the implantation site is determined by urethral length and mobility and the type of sling [39][40][41][42][43].…”

Urogynecology Section of the Polish Society of Gynecologists and Obstetricians Guideline on the use of urodynamic testing in gynecological practice

“…Their physical examination shows no signs of post-void residual (PVR) volume of > 100 mL or POP beyond the hymen. These patients also have normal urethral mobility and absence of urethral abnormality [7,8,10,11].…”