Three‐dimensional ultrasound of the urethral sphincter predicts continence surgery outcome

Abstract

The assessment of the urethral sphincter using a 3D ultrasound scan predicts the outcome of continence surgery.

Intraobserver and interobserver reliability of the three-dimensional ultrasound imaging of female urethral sphincter using a translabial technique

“…This is of significant clinical value as until recently, we have relied mainly upon functional assessments. However, with the progression of simple structural assessments (undertaken by accurate imaging techniques), we may be able to combine this information to influence our choice of management and predict surgical outcomes, as has been previously suggested [14]. However, ours is only a validation study showing normative values in asymptomatic non-pregnant, nulliparous women, and further research in women with lower urinary tract symptoms is needed to assess the clinical role of 3D imaging of the urethral sphincter.…”

“…The role of the urethral sphincter in the pathological development of urinary incontinence has been clearly postulated [12][13][14]. Although the importance of precise structural assessment of the urethral sphincter is paramount, the task of measuring it accurately has recently been met with conflicting opinions.…”

“…It has been shown to provide a more accurate measurement of urethral sphincter volumes than conventional 2D ultrasound [10], to correlate with cadaver specimens [11], to be a successful and sensitive tool in pregnant women [12] and in those with and without urinary incontinence [13], and it has also been demonstrated to be a promising preoperative tool in evaluating the outcome of continence surgery [14,15].…”

Urinary Tract Infections and Dysfunctional Voiding

“…In their study, Khullar et al averaged the bladder wall thickness at the trigone, dome, and anterior bladder wall to develop criteria for detection of detrusor overactivity, others assumed that measurement of the bladder dome is sufficient to define bladder wall thickness, even if they did not find that women with detrusor overactivity had an appreciably thicker bladder wall than other study groups (Khullar et al, 1996;Yang & Huang, 2003). US has also been shown to be a reproducible method of assessing urethral sphincter volume (Digesu et al, 2009). Using 2D ultrasound, on axial US images the normal urethra has a characteristic target-like appearance and is seen as composed by four concentric rings of different echogenicity (Minardi et al, 2007).…”

Preoperative urethral parameters at rest and objective cure following laparoscopic colposuspension

“…Recently Digesu et al showed that three-dimensional ultrasound of the urethral sphincter could predict outcome following Burch colposuspension [11]. Studies on urethral retroresistance pressure (the pressure required to achieve and maintain an open urethral sphincter) have demonstrated contradictory results regarding surgical outcome [12][13][14][15].…”