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

Shi, Qiang; Wen, Liang; Zhao, Baihua; Huang, Shanya; Liú, Dan

doi:10.1002/jum.15748

Cited by 7 publications

(8 citation statements)

References 28 publications

(73 reference statements)

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“…During CST, the patient is asked to cough or perform Valsalva maneuver forcefully, and the examiner directly visualized the urethral meatus for the presence of leakage. TPUS during CST can describe urethral mobility in real conditions of SUI 5,10 …”

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confidence: 99%

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The Visualized Urethral Mobility Profile in Stress Urinary Incontinence Described by Four‐Dimensional Transperineal Ultrasound

Zhao

Wen

Liú³

et al. 2021

J of Ultrasound Medicine

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Objectives-To describe the urethral mobility during urine leaking in stress urinary incontinence (SUI) by transperineal ultrasound (TPUS) with urethral mobility profile (UMP) analysis.Methods-This was a prospective study of 380 women who had a cough stress test (CST) with TPUS. UMP software automatically placed six equidistant points from the bladder neck (Point 1) to the external urethral meatus (Point 6) and determined their x and y coordinates relative to the symphysis pubis. Urethral mobility vector of Points 1-6 (Vectors 1-6) and the distance between the six points and the symphysis (Dist. 1-6) were calculated and compared between the two groups. The visualized UMP was created by reproducing the positions of the six points at rest and on Valsalva.Results-Valid data of 188 women with SUI and 174 continent women were analyzed. The mean age of all 362 women was 49.3 years. Mean body mass index in the SUI group was significantly increased (23.8 vs 22.2 kg/m 2 , P < .001). During CST, Vectors 1-6 and Dist. 2-6 were significantly increased (all P < .005) in the SUI group. The UMP showed the mid-urethral rotated down around the symphysis pubis. The upper urethral profile in the two groups was similar. But the gap between the mid-urethra and the symphysis was wider in the SUI group.Conclusions-The visualized UMP illustrated the mid-urethral hypermobility in SUI by showing a wider gap due to the unstable connection between the mid-urethra and the symphysis pubis.

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confidence: 99%

“…TPUS during CST can describe urethral mobility in real conditions of SUI. 5,10 This study aimed to describe the urethral morphology and mobility during urine leaking using four-dimensional TPUS with a visualized UMP.…”

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confidence: 99%

The Visualized Urethral Mobility Profile in Stress Urinary Incontinence Described by Four‐Dimensional Transperineal Ultrasound

Zhao

Wen

Liú³

et al. 2021

J of Ultrasound Medicine

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“…During Valsalva, the distance between the mid-urethra and the symphysis was much longer. This represented weak support of the mid-urethra in SUI and explained the mid-urethral hypermobility and its predicted performance in SUI [9,10,11]. Anatomic study and MRI provided evidence of the damaged mid-urethral support in SUI [20,21,22,23,24].…”

Section: Discussionmentioning

confidence: 97%

“…There were differences regarding bladder neck configuration and mobility during urinary leakage in supine and standing positions 3 . However, the mid-urethral mobility rather than the bladder neck mobility may account for SUI 11 .…”

Section: Introductionmentioning

confidence: 99%

Visualized Urethral Mobility Profile During Urine Leakage in Supine and Standing Positions

et al. 2022

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Objectives To describe the urethral course and position during urine leakage based on the visualized urethral mobility profile (UMP) and to explore the differences between supine and standing positions. Method This was a prospective study of 100 women with SUI and 100 control women who underwent a cough stress test (CST) with transperineal ultrasound (TPUS) in supine and standing positions. In the mid-sagittal plane, the UMP software automatically placed six equidistant points from the bladder neck (point 1) to the external urethral meatus (point 6). It determined the x and y coordinates of the points relative to the symphysis pubis. The distance between the points and symphysis pubis (dist. 1 to 6) was calculated using the formula SQRT (x2 + y2). The visualized UMP was created by reproducing the six points on a bitmap. Results Valid UMP data of 78 control women and 90 women with SUI were analyzed. In the two positions, distances 1 to 6 were significantly greater in the SUI group than the continent group (all p < 0.05). During Valsalva, the distance between the mid-urethra (dist. 3 and 4) and the symphysis was significantly increased (all p < 0.001) in the SUI group. The visualized UMP showed a similar upper-urethral course in the two groups. The gap between the mid-urethra (points 3 and 4) and symphysis was wider in the SUI group. Conclusion The visualized UMP in supine and standing positions showed no difference in the bladder neck and upper urethral stability between incontinent and continent women, but mid-urethral stability was weaker in SUI.

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“…7,8 The pathophysiology of UI in pregnancy is multifactorial, 7 including reduced bladder/urethral tone, weight gain, and urethral hypermobility. 9 Currently, limited studies have been conducted in Pakistan to explore the prevalence of the condition. We aimed to determine the frequency of UI, its types, risk factors, and impact on QOL of pregnant women presenting at our hospital.…”

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confidence: 99%

Female Urinary Incontinence: Frequency, Risk Factors, and Impact on the Quality of Life of Pregnant Pakistani Women

2023

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Objectives: To determine the frequency and associated risk factors of urinary incontinence (UI), and its effect on the quality of life (QOL) of pregnant Pakistani women. Methods: This was a cross-sectional study of 309 pregnant women, 16-40 weeks gestation, age 18- 45 years, at the Aga Khan University Hospital Karachi, between August 2019 and February 2020. Data were obtained using the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short form (ICIQ-UI-SF). Results: The frequency of UI was 63.1%. Stress UI was the commonest type (53.0%) followed by urgency (17.5%) and mixed UI (11.7%). In majority of women, it occurred in small amounts, once a week with a very severe impact on QoL in 24.91% of women, affecting sexual relation the most. Risk factors for UI in pregnancy were age > 35 years (p < 0.02), gestation > 37 weeks (p< 0.00), higher body mass index and family history of UI (p< 0.00), previous instrumental vaginal delivery (P < 0.002), cough, constipation and strenuous job (p< 0.00), and lack of pelvic ﬂoor muscle exercises (p <0.03). Conclusions: UI is a common problem in pregnant women in Pakistan. It affects sexual functions the most, with a severe impact on the QOL, however, it commonly remains unreported. Thus the health care providers need to enquire all pregnant women on this issue, especially those at risk, and educate them on the available management options. doi: https://doi.org/10.12669/pjms.39.3.6313 How to cite this: Abrar S, Mohsin R, Samad A. Female Urinary Incontinence: Frequency, Risk Factors, and Impact on the Quality of Life of Pregnant Pakistani Women. Pak J Med Sci. 2023;39(3):667-671. doi: https://doi.org/10.12669/pjms.39.3.6313 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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

Cited by 7 publications

References 28 publications

The Visualized Urethral Mobility Profile in Stress Urinary Incontinence Described by Four‐Dimensional Transperineal Ultrasound

The Visualized Urethral Mobility Profile in Stress Urinary Incontinence Described by Four‐Dimensional Transperineal Ultrasound

Visualized Urethral Mobility Profile During Urine Leakage in Supine and Standing Positions

Female Urinary Incontinence: Frequency, Risk Factors, and Impact on the Quality of Life of Pregnant Pakistani Women

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