ABSTRACT
Objective:To assess the urethral mobility of normal parous women in China and explore the impacts of related risk factors on it using translabial ultrasound.Methods:Females who met the inclusion criteria in 37 tertiary hospitals from February 2017 to August 2018 were included. All women underwent standardized translabial ultrasound examination and the urethral rotation angle (URA), bladder neck position at maximum Valsalva maneuver (BNP-V) and bladder neck descent (BND) were measured. Questionnaires were used to collect basic information including age, height, weight, body mass index (BMI), past medical history, maternity history, and urinary incontinence related history. Mann-Whitney U test and multiple linear regression analysis were adopted to explore the influences of age, BMI, delivery mode and parity on normal parous women′s urethral mobility. Then, the study subjects were divided into different groups and the corresponding values of URA, BNP-V and BND were compared. Results:Compared with parous women with normal BMI and no history of vaginal delivery, those who were overweight and/or had a history of vaginal delivery were more likely to gain greater URA and BND ( P<0.05). The URA and BND were not significantly different between women with different times of cesarean sections ( P>0.05); while for women with a history of vaginal delivery, these two parameters increased with the increase of the number of transvaginal deliveries ( P<0.05). Conclusions:BMI and vaginal delivery are important risk factors for the urethral mobility of normal parous women. The urethral mobility increases with the increase of BMI and the number of vaginal deliveries.
ABSTRACT
Objective To evaluate the effect of ultrasound-guided botulinum toxin A injection into the salivary glands in treating patients with sialorrhea attributable to brain damage.Methods Nine subjects with sialorrhea attributable to traumatic brain injury (n =5),cerebral infarction (n =3) and hypoxic ischemic encephalopathy (n =1) were recruited into the study.With the guidance of ultrasound,15 units (U) of botulinum toxin type A was injected into the highest and lowest points of the two parotid glands,and 20 U was injected into two points of both submandibular glands.The saliva flow rate and the severity and frequency of sialorrhea were recorded before the treatment and 1 week,4 weeks and 12 weeks later using the Drooling Scoring System (DSS).Results The saliva flow rate before treatment (0.49 ± 0.12 g/min) decreased significantly to 0.24 ± 0.08 g/min after 1 week,but then increased again to 0.28 ±0.12 g/min after 4 weeks and 0.34 ±0.11 g/min after 12 weeks.The average DSS severity score showed the same pattern:4.35 ± 0.48 initially 1.92 ± 0.37 after 1 week,1.92 ± 0.37 after 2 weeks and 2.32 ± 0.64 after 12 weeks.The DSS frequency score,however,remained significantly lower:3.56 ± 0.49 initially,2.01 ± 0.42 after 1 and 4 weeks and 2.28 ± 0.63 after 12 weeks.Conclusion Botulinum toxin type A can effectively improve the salivary secretion and sialorrhea attributable to brain damage.