Three-Dimensional Transperineal Ultrasonography for Diagnosis of Female Occult Stress Urinary Incontinence

Yin, Yitong; Xia, Zhijun; Feng, Xiaoyu; Li, Meng; Qin, Meiying

doi:10.12659/msm.917086

Cited by 15 publications

(8 citation statements)

References 24 publications

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“…The bladder neck is located at the junction of the middle and lower third of the pubic symphysis, usually being higher than the pubococcygeal line (the line between the lower edge of the pubic symphysis and the coccyx tip) [ 40 , 41 ]. The angle between the proximal urethral axis and the horizontal tangent line of the bladder base is the posterior vesicourethral angle [ 42 , 43 ], which is normally between 90° and 110°. When the bladder neck is closed at a right angle, the proximal urethra has the strongest closing performance and the greatest resistance.…”

Section: Anatomical Factors Affecting the Urethra ( Figure ...mentioning

confidence: 99%

The Anatomical Pathogenesis of Stress Urinary Incontinence in Women

et al. 2022

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Stress urinary incontinence is a common disease in middle-aged and elderly women, which seriously affects the physical and mental health of the patients. For this reason, researchers have carried out a large number of studies on stress urinary incontinence. At present, it is believed that the pathogenesis of the disease is mainly due to changes related to age, childbirth, obesity, constipation and other risk factors that induce changes in the urinary control anatomy, including the anatomical factors of the urethra itself, the anatomical factors around the urethra and the anatomical factors of the pelvic nerve. The combined actions of a variety of factors lead to the occurrence of stress urinary incontinence. This review aims to summarize the anatomical pathogenesis of stress urinary incontinence from the above three perspectives.

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Section: Anatomical Factors Affecting the Urethra ( Figure ...mentioning

confidence: 99%

The Anatomical Pathogenesis of Stress Urinary Incontinence in Women

et al. 2022

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“…Yin et al believed that the longer the funnel shape is, the greater the probability of SUI. 31 Finally, we developed a nomogram model based on the combined model because it can provide more intuitive and accurate results. We evaluated the efficiency of the nomogram, and the results showed that the discrimination of the nomogram was satisfactory, with AUCs of 0.848 and 0.872 in the training and validation cohorts, respectively, which were superior to those of the previous prediction model based on clinical risk factors alone.…”

Section: Discussionmentioning

confidence: 99%

Nomogram Analysis Based on Clinical and Sonographic Characteristics for the Assessment of Postpartum Stress Urinary Incontinence

Xiao

Cao

Zhen

et al. 2023

J of Ultrasound Medicine

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ObjectivesWe aimed to develop and validate a nomogram integrating clinical and sonographic characteristics for the individualized SUI risk evaluation in the early postpartum stage.MethodsThis was a prospective cross‐sectional study. From June 2020 to September 2022, singleton primiparas who underwent TPUS examination at 6–8 weeks postpartum were recruited. They were divided into the training and validation cohorts at a ratio of 8:2 according to the temporal split. All subjects were interviewed before TPUS examination. Univariate and multivariate logistic analyses were performed to develop three models: the clinical, sonographic, and combined models. The ROC curve was plotted to evaluate model discrimination ability. Finally, the combined model was selected to establish the nomogram. The nomogram's discrimination, calibration, and clinical usefulness were evaluated in the training and validation cohorts.ResultsThe performance of the combined model was better than that of the clinical and sonographic models. Six predictors (BMI, delivery mode, lateral episiotomy, SUI during pregnancy, cystocele, and bladder neck funneling) remained in the combined model. The nomogram based on the combined model had good discrimination with AUCs of 0.848 (95% CI: 0.796–0.900) and 0.872 (95% CI: 0.789–0.955) in the training and validation cohorts, respectively, and the calibration curve showed good efficiency in assessing postpartum SUI. Decision curve analysis showed that the nomogram was clinically useful.ConclusionsThe nomogram based on clinical and sonographic characteristics showed good efficiency in assessing postpartum SUI risk and can be a convenient and reliable tool for individual SUI risk assessment.

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“…Patients in our study emptied both rectum and bladder before the examination, while some other studies had acquired dynamic datasets imaging with a bladder volume of 200-300mL[28], or datasets with no more than 200 mL urine in the bladder [29]. This may result in a lack of pelvic oor morphological data at the leakage point.…”

Section: Discussionmentioning

confidence: 99%

Preoperative 4D pelvic floor ultrasound reduced the incidence of postoperative complication of TOT in female patients with SUI

Jiang

Zhang

Chen

et al. 2022

Preprint

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Background Stress urinary incontinence which has been associated with abnormal pelvic floor muscle function or morphology is a common condition. This research aims to evaluate the role of 4D pelvic floor ultrasound on the postoperative complication of transobturator suburethral tape (TOT) in female patients with SUI. Methods We enrolled 53 women with stress urinary incontinence (SUI). Before transobturator suburethral tape (TOT) procedures, the patients underwent 4D pelvic floor ultrasonography. The measurements include residual urine volume, bladder detrusor thickness in resting state, the vertical distance from the bladder neck to the posterior inferior edge of pubic symphysis at rest and Valsalva movement, posterior angle of bladder urethra (angle between the proximal urethra and outer wall of bladder triangle) and urethral rotation angle (angle between the proximal urethral axis and the middle axis of the human body). The degree of movement of the bladder neck (the difference between the vertical distance from the bladder neck to the posterior inferior edge of the pubic symphysis under the resting state and the maximum Valsalva movement) and the formation of a funnel at the internal orifice of the urethra were calculated. Results Mean bladder detrusor thickness was 2.6 ± 0.9 mm, the vertical distance from the bladder neck to the posterior inferior edge of pubic symphysis was 27.7 ± 4.5 mm, posterior angle of the bladder was 122.7 ± 18.9°, the vertical distance from rectal ampulla to the posterior inferior edge of pubic symphysis was 18.5 ± 4.6 mm, and the mean area of hiatus of the levator ani muscle was 22.1 ± 6.0 cm2. Preoperative ultrasound measurements during the Valsalva movement were summarized in Table 3. The mean posterior angle of the bladder on Valsalva was 159.3 ± 23.1° and mean urethral rotation angle was 67.2 ± 21.4°. Conclusions 4D pelvic floor ultrasound is a reliable method in evaluating preoperational morphological characteristics of patients with SUI. These datasets could help with reducing the incidence of complications associated with TOT procedures.

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Three-Dimensional Transperineal Ultrasonography for Diagnosis of Female Occult Stress Urinary Incontinence

Cited by 15 publications

References 24 publications

The Anatomical Pathogenesis of Stress Urinary Incontinence in Women

The Anatomical Pathogenesis of Stress Urinary Incontinence in Women

Nomogram Analysis Based on Clinical and Sonographic Characteristics for the Assessment of Postpartum Stress Urinary Incontinence

Preoperative 4D pelvic floor ultrasound reduced the incidence of postoperative complication of TOT in female patients with SUI

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