Bladder neck circulation by Doppler ultrasonography in postmenopausal women with urinary stress incontinence

Tsai, Eing‐Mei; Yang, Chengwu; Chen, Hung-Sheng; Wu, Ching-Hu; Lee, Jau-Nan

doi:10.1016/s0029-7844(01)01379-5

Cited by 21 publications

(15 citation statements)

References 21 publications

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Section: Discussionmentioning

confidence: 98%

“…It has been reported that estrogen deficiency has effects on the female lower urinary tract similar to those in the reproductive tract8, 17, 18. Hypoestrogenism may be responsible for the higher vascular resistance to urethral blood flow in postmenopausal women8, 19. Pinggera et al 19 reported that topical estrogen was associated with increased power Doppler signal intensity and reduced RI of the urethral arteries, but Girao et al 17 did not find that systemic estrogen therapy had any effect on vascular resistance of the urethral vessels.…”

Section: Discussionmentioning

confidence: 99%

“…Several factors contribute to the maintenance of urethral closure, including the actions of estrogen on various tissues and also suburethral blood flow6, 7. Estrogen replacement may result in increased intraurethral pressure and improve continence in postmenopausal women with urodynamic stress incontinence (USI)8, 9, although this postulate is still controversial10, 11.…”

Section: Introductionmentioning

confidence: 99%

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Functional correlates of Doppler flow study of the female urethral vasculature

Yang

Huang

2006

Ultrasound in Obstet & Gyne

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Functional correlates of Doppler flow study of the female urethral vasculature

Yang

Huang

2006

Ultrasound in Obstet & Gyne

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“…It is known, that the doppler flow spectrum may be impaired by a number of factors such as ageing, body mass index, menopause, sex hormones profile,(Yang et al 2006; Kobata et al 2008; Tsai et al 2001; Jármy-Di Bella et al 2000; Palmieri et al 2007; Miodrag et al 1988) movement and breathing artifacts as well as by the ultrasonographic access and equipment used (Wieczorek et al 2011). Until now, the most widely used ultrasound technique has been the transperineal/translabial approach.…”

Section: Discussionmentioning

confidence: 99%

Vascularity of the urethra in continent women using colour doppler high-frequency endovaginal ultrasonography

et al. 2014

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ObjectivesTo assess the urethral vascularity in continent women using colour doppler high frequency endovaginal ultrasonography (EVUS).MethodsWe recruited 61 continent women attending gynaecology clinics between July and October 2009. Exclusion criteria included symptoms of urinary incontinence, voiding dysfunction, pelvic organ prolapse or urinary tract infection. The participants underwent EVUS using high frequency (9-12 MHz) biplane transducer (type 8848 BK Medical), according to a standardised protocol. Colour Doppler US was performed in sagittal plane and in transverse plane at the level of the mid-urethra. Ten seconds video files were recorded and following vascular parameters: flow velocity (Vmix), area of the vessels (Amix), intensity of vascularity (Imix), pulsatility index (PImix) and resistance index (RImix) was evaluated.ResultsThere were 30 nulliparous (49.2%) women and 31 multiparous women (50.8%) with a mean (±SD) age of 32 (±4) and 46 (±6) years respectively. Significant impairment of vascularity was observed in multiparous patients as compared to nulliparous and was reflected by increased values of RImix (p < 0.001) and PImix (p < 0.001), and decreased values of Vmix (p < 0.001), Amix (p < 0.001), Imix (p < 0.001) in axial and midsagittal sections of the midurethra. A significant decrease of mean value ± SD of Imix- from 0.02 ± 0.02 in nulliparous to 0.005 ± 0.01 in multiparous was observed.Cronbach alpha, used to assess vascular correlations and parity demonstrated a reduction when expressed only for vascular parameters, indicating that number of deliveries is an important factor while assessing urethral vascularity.ConclusionsCompared to continent nulliparous women, continent multiparous women demonstrated a significant reduction in the vascularity parameters in all measured variables when parity was accounted for.Advances in knowledgeThis study provides the basis for further research in assessing urethral vascularity in women.

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“…Ultrasound imaging of periurethral tissue for analysis of its blood supply has been independently proposed by Tsai and Liang. In the first study, hormone replacement therapy was found to result in a significant decrease of the pulsatility index in the BN area and in a subjective improvement of UI in 17 of 31 women 9. In the second study, decreased periurethral vessels and flow was found in women suffering from SUI when compared to controls, suggesting a possible role of urethral vasculature in the pathophysiology of SUI 10.…”

Section: Methodsmentioning

confidence: 93%

Ultrasound imaging of the pelvic floor: Where are we going?

Tubaro

Koelbl

Laterza

et al. 2011

Neurourology and Urodynamics

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We produced a non systematic review of ultrasound imaging of the pelvic floor in women with urinary incontinence (UI) and/or pelvic organ prolapse (POP). We have searched the PubMed and Embase databases for the following PICO question: women; imaging; urinary incontinence, pelvic organ prolapse, pelvic floor, pelvic floor muscle, pelvic floor muscle training; physical examination, no imaging; diagnosis, prognosis, outcome. The production of a systematic review was deemed impossible based on the type and quality of the published evidence. Clinical research focused on the pathophysiology of the UI and POP looking relation between anatomic abnormalities, childbirth, the risk of UI or POP, the outcome of conservative treatment and reconstructive surgery. Published papers fall into the remits of diagnostic studies but often fail to comply with the recommendations of the STARD initiative. Most published evidence remains the product of a single institution effort and confirmatory studies are rarely found. Imaging studies in patients with UI did not provide evidence of any clinical benefit in the management of patients. In patients with POP, interesting correlations have been identified such as between childbirth, dimension of levator hiatus, avulsion of levator ani and risk of prolapse, but the non clinical benefit of pelvic floor imaging could still not be identified. Research on pelvic floor imaging requires a coordinated, international, multicentre effort to improve internal and external validity of imaging techniques, confirm observations published by single institutions and provide health technology assessment of imaging in the management of UI or POP patients.

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Bladder neck circulation by Doppler ultrasonography in postmenopausal women with urinary stress incontinence

Abstract: The blood flow around the bladder neck in women can be measured by perineal color Doppler ultrasonography. Hormone replacement therapy increases the blood flow around the bladder neck in postmenopausal women with USI. The clinical improvement of USI can be seen with HRT after 3 months.

Cited by 21 publications

References 21 publications

Functional correlates of Doppler flow study of the female urethral vasculature

Functional correlates of Doppler flow study of the female urethral vasculature

Vascularity of the urethra in continent women using colour doppler high-frequency endovaginal ultrasonography

Ultrasound imaging of the pelvic floor: Where are we going?

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