ABSTRACT
Objective:To discuss and analyze the clinical efficacy and application value of transperineal ultrasound dynamic monitoring for the contraction function of pelvic floor muscle to guide training based on its feedback in the treatment of stress incontinence of female.Methods: 169 female patients with stress incontinence were enrolled this study. And all of them were treated by using the Koegel physical training of pelvic floor muscle under the guidance of doctor, at the same time, the relative contraction function indicators of pelvic floor muscle before and after treatment were observed and compared by applied transperineal ultrasound dynamic monitoring.Results: The differences between before and after treatment of physical training on pelvic floor muscle about the length of the levator hiatus, the acreage of pelvic diaphragm hiatus, and the perimeter of pelvic diaphragm hiatus in contraction and silent period were significant (t=-2.858,t=-2.949,t=-4.899,P<0.05), and that of after treatment was higher than that of before treatment. The horizontal distance of pubis combined with margo inferior, vertical distance and thickness of viscera on pubis of after treatment were significant higher than that of before treatment (t=3.674, t=-4.899,t=4.230,P<0.05). The posterior urethra intersection angle and the intersection angle of left and right levator after treatment were significantly higher than that of before treatment (t=-4.087,t=6.584, P<0.05).Conclusion: Transperineal ultrasound dynamic monitoring can correctly evaluate the clinical efficacy of the contraction function of pelvic floor muscle to guide training based on its feedback in the treatment of stress incontinence of female. And this method has important clinical value.
ABSTRACT
PURPOSE: This study was designed to determine the diagnostic availability of transperineal ultrasongraphy compared with chain cystourethrography for patients with stress urinary incontinence. MATERIALS AND METHOD: Twenty-seven outpatient women with stress urinary incontinence, who underwent both transperineal ultrasonography and chain cystourethrography for the last ten months, participated in this study. The mean age was 47 years(range 37 to 66 years). The posterior urethrovesical angle(PUVA) at lest and during strain, and both an increment of PUVA and bladder neck descent during strain were measured in the two methods, respectively. Wilcoxon Matched-Pairs Signed-Ranks test was used for the comparative analysis of the results. RESULTS: The mean of PUVAS at rest and during strain were 118.9 degrees and 142.3 degrees, respectively, and the mean of the increment of PUVAS during strain was 23.5 degreesin transperineal ultrasonography. The mean of PUVAS at rest and during strain were 130.7 degrees and 158,0 degrees, respectively, and the mean of the increment of PUVAS during strain was 27.3 in chain cystourethrography. There were statistically significant differences in PUVAS, but no significant differences in the increment of PUVAS during strain between the two methods. During strain condition, the mean descent of bladder neck was 11.8mm in transperineal ultrasonography and 13.7mm in chain cystourethrography, and there were no significant differences between the two methods. CONCLUSIONS: Compared with chain cystourethrography, the transperineal ultrasonography made no significant differences in the diagnosis of stress urinary incontinence using both the increment of PUVAS and the bladder neck descent caused by the increase of abdominal pressure during strain. In addition, the transperineal ultrasonography is considered to be replaceable for chain cystourethrography, as that is noninvasive, devoid of risks of irradiation, and removes the noticeable discomfort or embarrassment for the patient in the diagnosis of stress urinary incontinence.