Ultrassonografia uretrovesical como método eficaz de avaliação dos parâmetros prognósticos de tratamento cirúrgico da incontinência urinária de esforço / Urethrovesical ultrasonography as an effective method for evaluating prognostic parameters in the surgical management of stress urinary incontinence

OBJETIVO: Comparar parâmetros ultrassonográficos relacionados à junção uretrovesical e uretra proximal em pacientes curadas e não curadas, tratadas cirurgicamente pela técnica de Burch, com a finalidade de estabelecer se há correspondência com fatores prognósticos. MATERIAIS E MÉTODOS: Trinta pacientes foram selecionadas e divididas em dois grupos: 15 consideradas clinicamente curadas e 15 consideradas não curadas. As pacientes foram submetidas a ultrassonografia transvulvar no pré-operatório e aos 30 e 180 dias do pós-operatório. RESULTADOS: No pré-operatório, o deslocamento da uretra proximal foi maior nas pacientes curadas (15,87 ± 4,55 mm × 12,47 ± 3,52 mm - p < 0,05). No pós-operatório, no esforço, a distância vertical da junção uretrovesical e a uretra proximal foram maiores nas pacientes curadas (12,87 ± 5,80 mm × 5,13 ± 6,55 mm - p < 0,01; e 13,07 ± 6,44 mm × 6,20 ± 6,14 mm - p < 0,01), e o deslocamento vertical da junção uretrovesical e da uretra proximal foi maior nas pacientes não curadas (8,47 ± 3,98 mm × 5,13 ± 2,36 mm - p < 0,001; e 8,33 ± 4,54 mm × 5,20 ± 2,90 mm - p < 0,05). CONCLUSÃO: A ultrassonografia da junção uretrovesical e da uretra proximal pode ser considerada como um método eficaz de avaliação dos parâmetros prognósticos do tratamento cirúrgico de mulheres com incontinência urinária de esforço.

OBJECTIVE: To compare sonographic parameters related to the urethrovesical junction and proximal urethra in cured and not cured patients surgically treated with the Burch technique, for establishing a possible correlation with prognostic factors. MATERIALS AND METHODS: Thirty female patients were selected and divided into two groups: 15 patients considered as clinically cured and 15 not cured. The patients were submitted to preoperative transvulvar ultrasonography, with the examination being repeated at the 30th and 180th postoperative days. RESULTS: At the preoperative examination, the proximal urethra displacement was largest in the cured patients (15.87 ± 4.55 mm × 12.47 ± 3.52 mm - p < 0.05). At the postoperative examination, with strain, the vertical distance of the urethrovesical junction and the proximal urethra were largest in the cured patients (12.87 ± 5.80 mm × 5.13 ± 6.55 mm - p < 0.01; and 13.07 ± 6.44 mm × 6.20 ± 6.14 mm - p < 0.01), and the vertical displacement of the urethrovesical junction and proximal urethra was largest in the not cured patients (8.47 ± 3.98 mm × 5.13 ± 2.36 mm - p < 0.001; and 8.33 ± 4.54 mm × 5.20 ± 2.90 mm - p < 0.05). CONCLUSION: Ultrasonography of the urethrovesical junction and proximal urethra can be considered as an effective method for evaluating prognostic parameters in the surgical management of women with stress urinary incontinence.

Value of Perineal Ultrasonography in Genuine Stress Urinary Incontinence / 대한비뇨기과학회지

The study was designed to determine the effectiveness of perineal ultrasonography compared with chain cystourethrography(CUG) in genuine stress urinary incontinence and to evaluate the diagnostic significance of perineal ultrasonography in 30 women with genuine stress urinary incontinence. The distinctive characteristic of perineal ultrasonography is simple, noninvasive, free of radiation exposure, comfortable, and not shameful out-patient procedure. We measured the posterior urethrovesical angle(PLRVA) at rest and during strain, and calculated the difference between the two angles. The mean value of PUVA at resting state were 134.7' in perineal ultrasonography group and 135.5' in chain CUG group(p=0.8235). During strain state, PLRVA was 146.2' in perineal ultrasonography group and 147.4' in chain CUG groupt=0.8341) The difference between PUVAs at rest and during strain was 12.1' in perineal ultrasonography group and 12.0' in chain CUG group(p=0.9022). The percentage of patients' subjective satisfaction with perineal ultrasonography was 96%, however the percentage of discomfort in chain CUG was 96%. In conclusion, perineal ultrasonography is a very comfortable and useful diagnostic method in genuine stress urinary incontinence, to replace chain CUG.