Comparison of Urodynamics and Perineal Ultrasound for Diagnosis of Mixed Urinary Incontinence in Women / 中国康复理论与实践

ABSTRACT

Objective To compare urodynamic studies (UDS) and perineal sonography for assessing mixed urinary incontinence (MUI) in women. Methods A total of 118 adult females with MUI and 30 controls were enrolled from September, 2010 to December, 2017. Their baseline clinical characteristics were recorded. The MUI patients were divided into stress-predomi-nant (S-MUI, n=51), urge-predominant (U-MUI, n=34) and equal predominance (E-MUI, n=33) according to King's Health Questionnaire. Both UDS and perineal sonography were performed in all the subjects. Tolerability of the two methods was compared. Results For sonography parameters, compared with the controls, S-MUI patients had greater dynamic posterior urethral angle, dynamic angle of urethral inclination, dynamic pubo-urethral distance and descent of bladder neck (P<0.001), U-MUI patients had greater detrusor thickness (P<0.05), and E-MUI patients had greater descent of blad- der neck (P<0.05). For UDS parameters, compared with the controls, S-MUI patients had lower Pure.clos.max and functional urethral length; U-MUI patients had lower Qmax, smaller bladder volume, higher Pdet.open, high-er Pdet.Qmax and higher incidence of detrusor overactivity; and E-MUI patients had higher Pdet.Qmax and low-er Pure.clos.max (P<0.05). All UDS and sonography parameters differed significantly between S-MUI and U-MUI patients. The descent of the bladder neck, dynamic angle of urethral inclination, and dynamic puboure-thral distance were negatively correlated with detrusor pressure at maximal flow and functional urethral length, while detrusor wall thickness was positively correlated with detrusor pressure at maximal flow and functional urethral length. Perineal ultrasound was better tolerated than UDS in 82.3% patients. Conclusion Perineal sonography parameters show good correlation with UDS parameters. Ultrasonography is better tol-erated than UDS and provides additional morphologic data. Perineal sonography could facilitate to diagnose U-MUI.