Three-dimensional Pelvic Floor Ultrasound Manifestations of Postnatal Early Stress Urinary Incontinence / 中国医学影像学杂志

ABSTRACT

Purpose To observe the shape of postnatal early female pelvic diaphragmatic hiatus and the mobility of lower urinary tract bladder neck with three-dimensional transperineal ultrasound,and to analyze the related parameters of postnatal early stress urinary incontinence (SUI) to screen SUI early after delivery and provide objective indices for pelvic floor rehabilitation.Materials and Methods 170 primiparae,including 13 cases of SUI group and 157 cases of asymptomatic group,were operated pelvic floor ultrasonic examination,human pelvic floor midsagittal sections and pelvic diaphragmatic hiatus rebuilding images were obtained,and such related biological parameters as bladder neck mobility and pelvic diaphragmatic hiatus indicators were determined.Results The incidence of SUI at 6-8 weeks after delivery was 4.55％,and that after vaginal delivery was 9.61％,the difference was not statistically significant (P＞0.05).The lower migration of the bladder neck (1.83±0.54) cm on Valsalva maneuver,and transverse diameter (421±0.73) cm,vertical diameter (5.89±0.97) cm and area (20.38±6.30) cm2 of pelvic diaphragmatic hiatus in SUI group were greater than those in the asymptomatic group (P＜0.05),and the difference between parameters of the two groups in resting state and anal shrinkage was of no statistical significance (P＞0.05).Conclusion The shape of urethra,lower migration of bladder neck and the parameters of pelvic diaphragmatic hiatus on Valsalva maneuver are sensitive indicators in ultrasonic evaluation of SUI,are conductive to screening of SUI after early delivery in combination with patient symptoms and can guide the high risk puerpera for early pelvic floor rehabilitation.