Translabial Ultrasonography in the Assessment of Urethral Diameter and Intrinsic Urethral Sphincter Deficiency

Abstract

Translabial ultra-sonography has an important role in the assessment of women with urinary stress incontinence and intrinsic urethral sphincter deficiency.

Transperineal ultrasound evaluation of females with stress urinary incontinence

“…10 Ultrasonography agreed with urodynamic study in the diagnosis of 100% of ISD patients, 66.75% urethral hyper mobility cases, and 71.5% of subjects having both conditions. 8 …”

“…15 Measurements are repeated till adequate strain is maintained. 10 Vertical component of bladder neck mobility was measured in 297 patients where mobility >10 mm was found in 97.1%, whereas mean mobility of 3.2 mm was measured in control subjects. 16 Demirci and Fine compared the vertical component of bladder neck mobility in control and SUI subjects and reported it to be similar at rest but differ significantly on stress.…”

“…That is why ultrasonography should be an essential modality in lower urinary tract assessment in patients complaining of UI. 10 Together with history, clinical examination and urodynamic; it has been shown to improve the accuracy of the diagnosis of the functional and morphological disorder.…”

Is it possible to diagnose intrinsic sphincter deficiency in women?

“…In 2006, Oliveira et al [34] demonstrated, using translabial ultrasonography, that ISD is associated with a large urethral diameter. A urethral diameter of greater than 6 mm showed sensitivity of 92% and specificity of 76% for ISD.…”

Urinary Tract Infections and Dysfunctional Voiding

“…Bladder neck mobility can be demonstrated by perineal or vaginal ultrasound and measured using the symphysis pubis as the immobile reference point; perineal ultrasonography allows visualization and measurement of the angle between the proximal mobile part and the distal fixed part of the urethra. Under these aspects US offers several advantages over other imaging modalities: using US urethral sphincter volume and detrusor wall thickness could be investigated in women with urinary incontinence, urinary retention and detrusor instability (Kondo et al, 2001;Schafer et al, 2002;Oliveira et al, 2006); in patients with detrusor overactivity a positive correlation was observed between rhabdosphincter thickness and detrusor contraction pressure, and between rhabdosphincter thickness and urethral resistance, and mean maximum urethral closure pressure and sphincter volume (Major et al, 2002;Wiseman et al, 2002). Sendag et al , applying perineal ultrasound, found that posterior urethro-vesical angle was significantly different both at rest and on straining in patients with stress incontinence, as well as the angle between the vertical axis and urethral axis and the descensus diameter (Sendag et al, 2003).…”