Ultrasonographic evaluation of urethrovesical junction mobility: correlation with type of delivery and stress urinary incontinence

Cosimato, Cosimo; Cipullo, Lucio; Troisi, Jacopo; Sardo, Attilio Di Spiezio; Tommaselli, Giovanni A.; Oro, Rosa; Zullo, Fulvio; Altieri, Vincenzo; Guida, Maurizio

doi:10.1007/s00192-015-2736-3

Cited by 6 publications

(4 citation statements)

References 34 publications

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“…After review by 2 reviewers, 16 studies were screened according to the inclusion and exclusion criteria. After careful reading, articles with too small sample size were excluded, and a total of 10 studies were included for meta-analysis (10)(11)(12)(13)(14)(15)(16)(17)(18)(19). The literature retrieval and screening process is illustrated in Figure 1.…”

Section: Literature Retrieval Processmentioning

confidence: 99%

Systematic review and meta-analysis of evaluation of selective cesarean section in postpartum pelvic floor function recovery under perineal ultrasound

Chen¹,

Geng²,

Zhou³

et al. 2022

Ann Palliat Med

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Background: Different delivery modes can affect the early pelvic floor function of puerpera, but there are no reports on the systematic evaluation of the effects of selective cesarean section delivery (CSD) and vaginal delivery (VD) on the pelvic floor function of puerpera.Methods: We searched for clinical controlled studies on the evaluation of pelvic floor function and performance after CSD and VD, published between 1 January 2010 and 1 August 2021, in the databases of PubMed, Embase, The Cochrane Library, and Web of Science. Literature was screened according to the inclusion and exclusion criteria. The quality of trials included in the studies was evaluated using the Cochrane Working Manual (5.3). Meta-analysis of the extracted data from the eligible articles was performed using Review Manager 5.3 software. The heterogeneity was assessed by chi-square, and P<0.05 was considered statistically significant among groups.Results: A total of 3,704 parturient women were included in 10 articles, including 1,072 cases in the CSD group and 2,632 cases in the VD group. Meta-analysis showed that pelvic floor muscle strength {mean difference (MD) [95% confidence interval (CI)]: −12.51 (−17.10 to −7.91); Z=5.34; P<0.00001} and bladder neck strength decreases in the CSD group [standardized mean difference (SMD) (95% CI): 1.01 (0.73 to 1.29); Z=7.08; P<0.00001] were higher than those in the VD group. In addition, the maximum urine flow [MD (95% CI): −6.86 (−9.32 to −4.39); Z=5.46; P<0.00001], bladder angle [MD (95% CI): −3.82 (−4.54 to −3.11); Z=10.46; P<0.00001], stress urinary incontinence (SUI) rate [relative risk (RR) (95% CI): 0.56 (0.35 to 0.88); Z=2.52; P=0.01], and pelvic floor organ prolapse rate [odds ratio (OR) (95% CI): 0.29 (0.09 to 0.89); Z=2.17; P=0.03] were lower than VD group, and the differences were significant (P<0.05). Conclusions:Selective CSD can reduce the injury of pelvic floor muscle during delivery to a certain extent, and reduce the incidence of SUI and pelvic floor organ prolapse in early puerpera; however, such impacts cannot be completely avoided.

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Section: Literature Retrieval Processmentioning

confidence: 99%

Systematic review and meta-analysis of evaluation of selective cesarean section in postpartum pelvic floor function recovery under perineal ultrasound

Chen¹,

Geng²,

Zhou³

et al. 2022

Ann Palliat Med

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“…The pelvic floor compression of the urethra reduced the intensity and caused the occurrence of SUI, where the supporting structure of anterior vaginal wall and the bladder neck were destroyed. The integral theory of pelvic floor involves focuses on urinary bladder, urethra, uterus, rectum, anus, other pelvic organs and the related muscles as a whole ( 7 ). Any defects in part of the pelvic floor may lead to an imbalance of these interactions, resulting in urethral pressure not being effectively maintained when abdominal pressure is increased, leading to SUI.…”

Section: Discussionmentioning

confidence: 99%

“…The probe made longitudinal incisions and the investigator freeze-framed the images (sonogram), including lower margin of the pubic bone, base of bladder, UVJ, urethra, vagina and sagittal image of rectum. A trackball was used to draw up the outline of base of bladder and UVJ ( 7 ). During the entire procedure, the patient remained in a relaxed state.…”

Section: Methodsmentioning

confidence: 99%

Value of UVJ-M in the diagnosis of SUI in late pregnancy and postpartum

Zhang¹,

Jiang²,

Guo³

et al. 2016

Experimental and Therapeutic Medicine

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Stress urinary incontinence (SUI) is a common pelvic floor dysfunctional disorder in which leakage of urine occurs when there is abdominal pressure. The aim of the present study was to determine the value of stress urinary incontinences (SUIs) in late pregnancy and postpartum via detection of the mobility of the ureterovesical junction (UVJ-M) by using transperineal ultrasound. The study involved the continuous and random selection of 120 cases of early pregnant women and single births. The patients were divided into the SUI and non-SUI groups dependent on whether there was leakage of urine when abdominal pressure in the form of coughing, laughing and sneezing, was increased. UVJ-M was measured, the receiver operating characteristic (ROC) curve was drawn up and the threshold value was predicted. The results showed that, the SUI prevalence was 7.5 (9/120), 22.5 (27/120), 43.3 (52/120), and 5.8% (7/100), respectively, in 34, 36, and 38 gestational weeks, and 6 weeks after delivery. The SUI prevalence gradually increased with the gestational weeks, and differences were statistically significant. UVJ-M values increased with the gestational weeks, at 3.43±1.52, 6.77±0.98 and 2.35±1.04 mm, respectively. Statistically significant differences were identified. Results of the ROC analysis, based on measurement of UVJ-M between the late pregnancy and non-SUI groups, revealed that the optimal threshold was 8.66 mm, corresponding to a sensitivity of 89.5% and specificity of 66.7%. In conclusion, UVJ-M ≥6.59 mm was identified as the predicted value of SUI during late pregnancy, and UVJ-M ≥8.66 mm the predicted value of SUI after delivery.

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“…Studies have shown that an increase in BND, URA and RVA is frequently found in SUI patients. 4 TPUS is a common examination for SUI and enables the evaluation of mobility of the bladder neck and proximal urethra. The normal recommendations from "Practical Pelvic Floor Ultra-sound Diagnosis" are as follows: BND < 25 mm, URA < 45° and RVA < 140°.…”

Section: Commentmentioning

confidence: 99%

Immediate effect of acupuncture on pelvic floor structure in stress urinary incontinence: a case report

Song

Ming

et al. 2022

Acupunct Med

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Ultrasonographic evaluation of urethrovesical junction mobility: correlation with type of delivery and stress urinary incontinence

Abstract: PVA and RVA are increased in pregnant women in comparison with controls. In patients undergoing VD, PVA is restored significantly later than in those undergoing CS. The change in RVA after pregnancy and delivery seems to persist longer than the change in PVA.

Cited by 6 publications

References 34 publications

Systematic review and meta-analysis of evaluation of selective cesarean section in postpartum pelvic floor function recovery under perineal ultrasound

Systematic review and meta-analysis of evaluation of selective cesarean section in postpartum pelvic floor function recovery under perineal ultrasound

Value of UVJ-M in the diagnosis of SUI in late pregnancy and postpartum

Immediate effect of acupuncture on pelvic floor structure in stress urinary incontinence: a case report

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