Transperineal ultrasonography in stress urinary incontinence

Authors

  • Vineet V. Mishra Department of Obstetrics and Gynecology, Institute of Kidney Diseases and Research Center and Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad, Gujarat, India
  • Smit B. Solanki Department of Obstetrics and Gynecology, Institute of Kidney Diseases and Research Center and Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20221451

Keywords:

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

Abstract

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.

References

Novara G, Artibani W. Imaging for urinary incontinence: a contemporary perspective. Curr Opin Urol. 2006;16(4):219-23.

Delancey J, Cardozo I and Staskin D. Textbook of female urology and urogynecology. 1st ed. London: Isis Medical Media; 2001:112-24.

Sendag F, Vidinli H, Kazandi M, Itil IM, Askar N, Vidinli B, Pourbagher A. Role of perineal sonography in the evaluation of patients with stress urinary incontinence. Aust N Z J Obstet Gynaecol. 2003; 43(1):54-7.

Schaer GN, Koechli OR, Schuessler B, Haller U. Perineal ultrasound: determination of reliable examination procedures. Ultrasound Obstet Gynecol. 1996;7(5):347-52.

Dietz HP. Ultrasound imaging of the pelvic floor. Part I: two-dimensional aspects. Ultrasound Obstet Gynecol. 2004;23(1):80-92.

Nitti VW. The prevalence of urinary incontinence. Rev Urol. 2001;3(1):S2-6.

Oliveira FR, Ramos JG, Martins-Costa S. Translabial ultrasonography in the assessment of urethral diameter and intrinsic urethral sphincter deficiency. J Ultrasound Med. 2006;25(9):1153-8.

Torella M, De Franciscis P, Russo C, Gallo P, Grimaldi A, Ambrosio D, Colacurci N, Schettino MT. Stress urinary incontinence: usefulness of perineal ultrasound. Radiol Med. 2014;119(3):189-94.

Yang JM, Huang WC. Discrimination of bladder disorders in female lower urinary tract symptoms on ultrasonographic cystourethrography. J Ultrasound Med. 2002;21(11):1249-55.

Al-Saadi WI. Transperineal ultrasonography in stress urinary incontinence: The significance of urethral rotation angles. Arab J Urol. 2016;14(1):66-71.

Minardi D, Piloni V, Amadi A, El Asmar Z, Milanese G, Muzzonigro G. Correlation between urodynamics and perineal ultrasound in female patients with urinary incontinence. Neurourol Urodyn. 2007;26(2): 176-82.

Sweed MS, Sharara S. Transperineal ultrasound evaluation of females with stress urinary incontinence. Int J Reprod Contracept Obstet Gynecol. 2016;5:637-41

Antovska VS. Ultrasound characteristics of patients with urinary stress incontinence with or without genital prolapse. Korean J Urol. 2012;3:691-98.

Pregazzi R, Sartore A, Bortoli P, Grimaldi E, Troiano L, Guaschino S. Perineal ultrasound evaluation of urethral angle and bladder neck mobility in women with stress urinary incontinence. BJOG. 2002;109(7): 821-27.

Kölbl H, Bernaschek G, Wolf G. A comparative study of perineal ultrasound scanning and urethrocystography in patients with genuine stress incontinence. Arch Gynecol Obstet. 1988;244(1):39-45.

Alper T., Cetinkaya M., Okutgen S., Kökçü A., Malatyalioğlu E. Evaluation of urethrovesical angle by ultrasound in women with and without urinary stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12:308-11.

Al-Khuzaee L.R., Al-Saadi W.I. Perineal ultrasound for evaluating bladder neck and urethra in stress urinary incontinence. Iraqi J Med Sci. 2012;10:367-74.

Gungor M., Salih M., Cengiz B. Transvaginal sonography in the evaluation of urinary stress incontinence. Gynecol Obstet Reprod Biol Med. 1997;3:436-8.

Hajebrahimi S, Azaripour A, Sadeghi-Bazargani H. Clinical and transperineal ultrasound findings in females with stress urinary incontinence versus normal controls. Pak J Biol Sci. 2009;12(21):1434-37.

Demirci F, Kuyumcuoglu U, Uludogan M, Gorgen H, Sahinoglu Z, Delikara MN. Evaluation of urethrovesical junction mobility by perineal ultrasonography in stress urinary incontinence. J Pak Med Assoc. 1996;46(1):2-5.

Downloads

Published

2022-05-26

Issue

Section

Original Research Articles