Transperineal ultrasound evaluation of females with stress urinary incontinence

Sweed, Mohamed S.; Sharara, Sherene

doi:10.18203/2320-1770.ijrcog20160479

Cited by 4 publications

(5 citation statements)

References 15 publications

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“…In the present study, we could not define a threshold value for α and β angle discriminating between the continent and incontinent women. Unlike Sweed and Sharara and some other studies, [20][21][22] we didn't find any correlation between bladder neck descent in continent and SUI group during straining. Bladder neck funneling defined as opening of the bladder neck during cough or Valsalva maneuver is introduced as a valuable ultrasonographic criterion for confirming SUI in incontinent patients.…”

Section: Discussioncontrasting

confidence: 99%

Correlation between trans-perineal ultra-sonography, urodynamic study and physical examination findings in female patients with stress urinary incontinence: Single center experience

et al. 2023

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Background: To evaluate the efficacy of Trans-perineal ultrasonography (TPUS) in assessment of stress urinary incontinence (SUI) and its correlation with urodynamic study (UDS) and physical examination in women with SUI. Methods: The study enrolled a total of 91 females including 66 women with SUI and 25 women with no history of urinary incontinence as control group. The α and β angles (anterior urethral and posterior urethro-vesical angle respectively) were recorded both at rest and at straining, using TPUS. The differences between these angles at rest and during the straining were considered as the rotational angles (Rα and Rβ). Urethral length and caliber, bladder neck funneling, and pubo-urethral distance were measured as well. Results: The mean (SD) α angle at rest of the SUI group was 49.0 (±14.3)°, which was higher than the same parameter in the control group: 47.6 (±9.7)°. Similarly, the α angle at straining was significantly higher in the SUI group versus the control group, 61.0 (±15.4)° versus 55.8 (±15.8)°. The mean (SD) β angle in the SUI group at rest was 124.6 (±28.5)°, which was significantly higher than that of the control group at 114.0 (±22.5)°. The mean (SD) β angle at straining was also higher in the SUI group versus the control group: 151.8 (±90.6) versus 136.0 (±27)°. Moreover, higher Rα and Rβ angels were documented in the SUI group. Conclusion: Our data suggest that TPUS can be considered as a non-invasive, easily conducted, and accurate modality in early diagnosis of female SUI. It may reduce the need for performing relatively invasive UDS. However, the role of TPUS in assessment of SUI severity remains to be studied probably with a larger sample size.

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Section: Discussioncontrasting

confidence: 99%

Correlation between trans-perineal ultra-sonography, urodynamic study and physical examination findings in female patients with stress urinary incontinence: Single center experience

et al. 2023

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“…However, the differences in mean values between studies could reflect the different severity of SUI in the selected populations. On the contrary, a survey by Sweed and Sharara, 27 a group comparison between 40 cases with SUI and 40 controls, indicated that the β angle did not differ between the groups at rest, whereas there was only a difference at straining. The discrepancy in the results could have been due to the differences in the anatomic characteristics of various races, which have been considered important in the SUI incidence 9 .…”

Section: Discussionmentioning

confidence: 93%

Prediction of Stress Urinary Incontinence Using the Retrovesical (β) Angle in Transperineal Ultrasound

Keshavarz

Pouya

Rahimi

et al. 2020

J of Ultrasound Medicine

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Objectives-The accurate, rapid diagnosis of stress urinary incontinence (SUI) in women can profoundly improve their sexual and psychosocial life. In this study, the diagnostic power of SUI was assessed by transperineal ultrasound.Methods-In this hospital-based case-control study, married women who were referred to the gynecologic and ultrasound wards with negative urinalysis and culture results were enrolled by random sampling. Patients with positive cough signs based on the urodynamic testing data were considered cases, whereas control women showed no cough symptoms and were recruited from the same ward.Results-There was a significant difference (P < .001) in bladder neck descent (mean AE SD, 10.89 AE 5.51 versus 7.08 AE 2.60 mm, respectively; P = .0001) and the retrovesical (β) angle with the Valsalva maneuver (144.22 AE 19.63 versus 111.81 AE 24.47 ; P < .001) between the case and control groups. Also, the β angle without the Valsalva maneuver was higher in the case group (112.35 AE 23.10 ) than the control group (120.17 AE 25.16 ; P = .001). There was no case of a urinary leak, urethral diverticulitis, a bladder stone or mass, and cystourethrocele in the patients of each group. The results of multivariate logistic regression with a backward method showed that bladder neck descent (odds ratio [OR], 1.24; 95% confidence interval [CI], 1.09-1.40), the β angles with and without the Valsalva maneuver (OR, 1.1; 95% CI, 1.06-1.13; and OR, 1.04; 95% CI, 1.01-1.06) were the predictors of SUI. A β angle higher than 127 with the Valsalva maneuver, with an area under the curve of 0.89 (95% CI, 0.75-0.96), could very well predict the SUI response. This finding shows that it can be very well used to distinguish between normal and non-normal responses, with 89% sensitivity and 79% specificity.Conclusions-The β angle with the Valsalva maneuver could very well predict the SUI response. Key Words-diagnosis; female urogenital diseases; retrovesical angle; stress urinary incontinence; transperineal ultrasound S tress urinary incontinence (SUI) is one of the crucial pelvic floor disorders, affecting many women around the world. 1 This disease occurs with an incidence rate ranging from 10% to 30% in different ethnicities/races. 2 Stress urinary incontinence is defined as unintended urine leakage by coughing, sneezing, lifting, or laughing, which can rigorously impair the patient's quality of life 3 and negatively affect her social and sexual life. Women with this problem will avoid social gatherings and lose

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“…There was a statistically significant difference comparing severe cases and mild cases, but no statistical significance comparing the moderate and severe cases. In a similar study, Sweed MS et al 8 found a mobility >10mm in cases with SUI while it was 3.2mm in control group. Other studies like Dietz HP 9 gave a wide range of bladder neck mobility in stress incontinence cases compared to the controls but without differentiating mild from moderate and severe cases.…”

Section: Discussionmentioning

confidence: 74%

“…In a similar study, Sweed Ms et al 8 found that urethral diameter was significant comparing patients with ISD and patients with SUI without ISD (6.64±1.23mm and 4.83±1.16mm respectively) (p=0.03). Also, Oliveira et al, 12 demonstrated similar results with mean urethral diameters in cases of SUI with ISD compared to those with SUI without ISD of 6.38mm and 4.91mm respectively.…”

Section: Discussionmentioning

confidence: 75%

Evaluation of transperineal ultrasound in diagnosis and grading of female genuine urinary stress incontinence

Lithy

2020

OGIJ

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Stress urinary incontinence (SUI) has an observed prevalence of between 4%and 35%. Purpose: To determine the role of transperineal ultrasound in diagnosing stress incontinence, its degree and the possible cause by: Measuring the BN descent, urethral hypermobility, funneling of BN or proximal urethra, urethral diameter, posterior urethra vesical angle, associated cystocele Using color Doppler to detect escape of urine through the urethra. Methods: 52 female patients diagnosed to have genuine stress incontinence using 3 day voiding diary, simple questionnaire and confirmed by standard urodynamics. Classification of stress incontinence into mild, moderate and severe using Valsalva leak point pressure during urodynamic study. Transperineal ultrasound for evaluation of the anterior pelvic compartment regarding: bladder neck descent, urethralhy permobility, Funneling of the BN, posterior urethrovesical angle ,urethral diameter, associatedcystocele, and finally the Doppler detection of urinary escape both at rest and with Valsalva maneuvers. Results: 28/52 cases (53.8%) of SUI didn’t show clinical evidence of cystocele; 11 cases (21.2%) showed grade 1 cystocele and 13cases (25%) showed grade 2 cystocele. The presence or absence of cystocele and also the grade of cystocele did not show a statistically significant relation to the degree of SUI; p=0.089 and 0.086 respectively Conclusion: We came to conclusion that transperineal ultrasound can be used in accurate diagnosis and grading of female urinary stress incontinence with our given cutoff values for bladder displacement, α angle, β angle and urethral diameters and from this grading by transperineal ultrasound comes the novelity of our research.

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Transperineal ultrasound evaluation of females with stress urinary incontinence

Cited by 4 publications

References 15 publications

Correlation between trans-perineal ultra-sonography, urodynamic study and physical examination findings in female patients with stress urinary incontinence: Single center experience

Correlation between trans-perineal ultra-sonography, urodynamic study and physical examination findings in female patients with stress urinary incontinence: Single center experience

Prediction of Stress Urinary Incontinence Using the Retrovesical (β) Angle in Transperineal Ultrasound

Evaluation of transperineal ultrasound in diagnosis and grading of female genuine urinary stress incontinence

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