Transvaginal ultrasound is a valuable investigation in female stress incontinence

ABSTRACT

Objectives: To evaluate the role of transvaginal ultrasound (TVUS) in studying the anatomical bases of genuine stress urinary incontinence (SUI) and understanding the causes of success and failure of operations aiming at the treatment of incontinence. Patients and Methods: This study included 15 continent females (Group I, healthy control) and 46 patients complaining of SUI (Group II). All cases were subjected to full history, physical examination, urodynamic evaluation and TVUS examination. In 42 patients of Group II, TVUS was repeated one year after treatment of incontinence, while four patients were lost to follow-up. In 36 of these 42 cases (85.7%), treatment was successful (Group IIIa), while treatment had failed and SUI had persisted or recurred within one year in six cases (Group IIIb, 14.3%). We used TVUS to measure the bladder-symphysis distance (BS), the rotational angle(RA), the bladder neck motility (BNM) and the vertical bladder neck descent. Results: While the mean BS was insignificantly shorter in Group II compared to Group I (2.24 ± 0.7cm versus 2.4 ± 0.5 cm, p = 0.08), the mean RA, BNM and vertical bladder neck descent were significantly larter in Group II (115 ± 17o 29 ± 16o 1.4 ± 0.4 cm for Group II versus 94 ± 15o 20 ± 5o 0.34 ± 0.4 cm for Group I). The comparison between Groups I and II showed that the TVUS-measured parameters correlated well with the clinical condition. A comparison between Group IIIa (BS = 2.2 ± 1 cm, RA = 100 ± 19o BNM = 22 ± 4o and vertical bladder neck descent = 0.38 ± 0.5 cm) and Group IIIb (BS = 2.2 ± 0.5 cm, RA = 117 ± 16o, BNM = 30 ± 9o and vertical bladder neck descent = 1.4 ± 0.3 cm) showed that the TVUS-measured parameters correlated well with the surgical outcome. Conclusions: TVUS is a valuable tool for the diagnosis and postoperative evaluation of SUI and may help in understanding the causes of success and failure of surgical treatment of SUI