Transperineal ultrasonography in stress urinary incontinence

Vineet V. Mishra, Smit B. Solanki


Background: The aim of our study is to assess, using transperineal ultrasonography, amount of bladder neck mobility using rotational angles; represented by the difference in the anterior (α angle) and posterior urethral angles (β angle) and proximal pubourethral distance at rest and straining, in stress urinary incontinence and control group, to ascertain if there are significant differences in their values between the groups.

Methods: In all, 24 women with SUI (SUI group) and 20 continent women (control group) were included. Transperineal ultrasonography was performed at rest and straining (Valsalva manoeuver), and the threshold value for the urethral angles (α and β angles) and proximal pubourethral distance for each group were estimated.

Results: A significant difference was found in calculating the numerical value of the increment of both α and β angles in both groups, at rest and at straining (rotation angle α and rotation angle β (Rα and Rβ)). Higher rotation angles were seen in the SUI group for both the α angle and the β angle compared with those of the control group; mean (SD) Rα SUI 29.37±7.46 vs. controls 10.83±3.46°; and Rβ SUI 27.97±7.47 vs. controls 13.00±3.16°; p<0.01. There was also significant difference in proximal pubourethral distance (<0.01) during resting and straining phases in patients with SUI.

Conclusions: Rotational angles and pubourethral distance helps in evaluation of stress urinary incontinence and reduces the need of urodynamic studies.


Pubourethral distance, Rotational angles, Stress urinary incontinence, Transperineal ultrasonography

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