The association between urethral configuration and mobility and female stress urinary incontinence investigated by transperineal ultrasound / 中华超声影像学杂志

ABSTRACT

Objective:To study the association between urethral configuration and mobility and female stress urinary incontinence (SUI).Methods:This was a prospective study in 176 women with pure SUI and 132 healthy women who undertook transperineal ultrasound in Second Xiangya Hospital between July 2017 and April 2020. Urethral funneling, bladder neck descent (BND) and rotation, retrovesical angle (RVA), and urethral mobility of 6 points along the urethra (Vectors 1 to 6) were measured by transperineal ultrasound during the cough stress test (CST). The differences between the two groups were tested using independent t-test. The relationship between ultrasound findings and SUI was analyzed by ROC curve and Logistic regression analysis. Results:Urethral funneling was found in 27.8% of women with SUI and 3.0% of controlled women.BND [(25.2±7.4)mm vs (21.5±8.6)mm], RVA [(171.5±26.3)° vs (159.4±26.6)°] and Vectors 1-6 [(2.97±0.89), (2.93±0.75), (2.67±0.67), (2.34±0.66), (2.27±0.67) , (2.36±0.69) vs (2.59±1.03), (2.54±0.83), (2.27±0.64), (1.99±0.50), (1.94±0.49), (2.05±0.53)] were significantly increased in SUI group (all P≤0.001). Logistic regression analysis yielded odds ratios of 10.06(95% CI=4.18-24.20), 2.71(95% CI=1.81-4.05) and 3.21(95% CI=2.01-5.14) for urethral funneling, Vector 3 and Vector 4 to predict for SUI, respectively. Conclusions:Transperineal ultrasound can be used to evaluate the real-time change of the bladder neck and urethral configuration and mobility in CST. Urethral funneling and mid-urethral hypermobility can be used to predict SUI.