Association between urethral funneling in stress urinary incontinence and the biological properties of the urethral rhabdosphincter muscle based on shear wave elastography

Wang, Liang; Liu, Yun; Wang, Xiaona; Shi, Guo-qiang; Huang, Jun; Xiao, Xue; Xie, Ying

doi:10.1002/nau.25080

Neurourology and Urodynamics

2022

DOI: 10.1002/nau.25080

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Association between urethral funneling in stress urinary incontinence and the biological properties of the urethral rhabdosphincter muscle based on shear wave elastography

Liang Wang

Yun Liu

Xiaona Wang

et al.

Abstract: Objectives: To apply shear wave elastography (SWE) combined with transperineal ultrasonography (TPUS) to study the association between urethral funneling in stress urinary incontinence (SUI) and the biological properties of the urethral rhabdosphincter muscle in women. Methods: This single-center retrospective study included 166 women with SUI (SUI group) and 185 women who underwent a routine physical examination (control group). The control group and SUI group were divided into nonfunneling and funneling grou… Show more

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2023

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Cited by 3 publications

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“…Wang et al reported that vacuum assisted delivery causes urethral sphincter injury leading to inability to relax the sphincter hence causing urinary retention 18. In our study there were 82(68.3%) cases with age ≤30 years and 38(31.7%) with age >30 years.…”

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confidence: 44%

Frequency of Post Partum Urinary Retention after Vaginal Delivery

Zafar,

Maqbool,

Rehman

et al. 2023

PJMHS

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Objective: To determine the factors responsible for postpartum urinary retention after vaginal delivery in women. Materials and methods: This is an observational study conducted in the department of obstetrics and gynecology Rai medical College Sargodha. Study was completed in six months duration from July 2022 to December 2022. Patients undergoing spontaneous vaginal delivery and experienced urinary retention till six hours postpartum were labelled as case of postpartum urinary retention (PPUR). Total 120 cases of PPUR were included in this study after following inclusion and exclusion criteria. Results: Frequency of PPUR after vaginal delivery was 10(8.3%). Main factors causing PPUR include epidural analgesia in 3(37.5%) and prolong duration of labor in 2(25%) cases. Mean age of the study cases was 27.8 ± 4.2 years. Mean gestational age was 38.12 ± 2.2 weeks. Practical Implication: In this study our aim was to assess risk factors developing postpartum urinary retention (PPUR) in women who underwent vaginal delivery in order to identify women with increased risk of developing symptomatic PPUR so that this problem may be noted in post natal care and may be managed properly. There is no previously sufficient data related to this problem in our population so this study will help us to understand the disease burden in our society. Conclusion: Main risk factors of postpartum urinary retention after vaginal delivery include prolonged labor and epidural analgesia. Keywords: Postpartum hemorrhage, Vaginal delivery, Risk factors, Urinary retention, Prolong labor,

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confidence: 44%

Frequency of Post Partum Urinary Retention after Vaginal Delivery

Zafar,

Maqbool,

Rehman

et al. 2023

PJMHS

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Technical feasibility of uro-dynamic MRI study of voiding biomechanics: a pilot study

Gonzalez-Pereira,

Johnson,

Wells

et al. 2023

Int Urol Nephrol

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Possibilities of elastography in the diagnosis of stress urinary incontinence in women

Rusina,

Zhevlakova,

Shelayeva

et al. 2023

Journal of obstetrics and women's diseases

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BACKGROUND:Stress urinary incontinence in women is a widespread disease. It can occur in women of reproductive age, while progressing and disrupting the quality of life. Ultrasound elastography allows for evaluating the stiffness of the urethral supporting structures and can help in studying the pathophysiology of stress urinary incontinence and in diagnosing its mild forms for timely initiation of therapy and preventing the development of severe forms of the disease. AIM:The aim of this study was to improve the diagnosis of mild stress urinary incontinence in women using ultrasound compression elastography of the ureterovesical junction. MATERIALS AND METHODS:We examined 25 women with mild stress urinary incontinence (main group) and 15 patients without urinary incontinence (control group) of reproductive and perimenopausal age. The diagnosis of stress urinary incontinence was confirmed during a comprehensive urodynamic study. To assess the urethral mobility and determine the stiffness of the supporting structures, a 2D ultrasound examination was performed with compression elastography of the ureterovesical junction using Voluson E6 and E10 ultrasound systems equipped with a transvaginal probe (GE Healthcare, USA). Four areas of interest in the paraurethral region of the proximal and middle urethra were examined. The obtained elastograms were used to evaluate the color characteristics and strain ratio of the areas of interest in three dimensions, the average values being calculated. RESULTS:The strain ratios in all studied areas of the paraurethral region had no significant relationship with age and were lower in patients with stress urinary incontinence compared to control values (p 0.01). Urethral hypermobility (mobility: mean urethral α angle rotation of 40 degrees) was identified in 84% of women with stress urinary incontinence. According to the results of correlation analysis, the strain ratios in the three areas of interest had a significant negative relationship with changes in the urethral α angle rotation. The ROC analysis showed that the stiffness values of the paraurethral region of the proximal posterior wall of the urethra are the most significant parameters for the diagnosis of stress urinary incontinence. The threshold value of the strain ratio for diagnosing stress urinary incontinence was determined to be less than or equal to 0.85 (sensitivity 96.0%; specificity 86.7%;p 0.001). CONCLUSIONS:Ultrasound compression elastography of the ureterovesical junction is a new non-invasive technique that can improve the accuracy of diagnosing stress urinary incontinence in women. It is advisable to use the technique in women with mild stress urinary incontinence who are planned for conservative treatment to confirm the diagnosis and monitor therapy.

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Association between urethral funneling in stress urinary incontinence and the biological properties of the urethral rhabdosphincter muscle based on shear wave elastography

Cited by 3 publications

References 20 publications

Frequency of Post Partum Urinary Retention after Vaginal Delivery

Frequency of Post Partum Urinary Retention after Vaginal Delivery

Technical feasibility of uro-dynamic MRI study of voiding biomechanics: a pilot study

Possibilities of elastography in the diagnosis of stress urinary incontinence in women

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