The Evaluation of Posterior Urethrovesical Angle, Urethral Length, Bladder Wall Thickness, and Residual Volume with Transperineal Ultrasonography in Women with Urinary Incontinence
Abstract
Objective: In the recent decades, transperineal ultrasonography has been used to examine patients in urogynaecology practice. In this study, we aimed to evaluate the function of transperineal ultrasonography in women with urinary incontinence.
Methods: Forty-five patients who were admitted to our institution between December 2012 and May 2013 and clinically and urodynamically diagnosed as having urinary incontinence (SUI n=20, DI+UUI n=13, MUI n=12) were included in the study. Additionally, 25 clinically and urodynamically continent women were included as the control group.
The patients were evaluated using transperineal ultrasonography (USG) in the supine position during rest and straining. An abdominal probe was placed in the perineum vertically and sagittally; when the symphysis pubis, urethra, bladder, vagina, and rectum could be seen clearly on the monitor, the image was frozen. Posterior urethrovesical angle (PUVA), urethral length, bladder wall thickness, and residual urine volume were measured on the image. All measurements were compared statistically between the SUI, UUI, MUI groups, and control group. The post-void residual volume measured using transperineal ultrasonography was compared with the post-void residual volume measured using a catheter during urodynamics.
Results: PUVA was significantly different in the SUI and MUI groups at rest than in the control group (p<0.05). During Valsalva maneuvers, PUVA was statistically significantly different in the SUI and MUI groups than in the UUI and control groups (p<0.01).
Conclusion: The measurement of PUVA and bladder wall thickness by transperineal ultrasonography is shown to be useful in diagnosis of patients with suspected detrusor instability and structural defects in pelvic floor. Therefore, transperineal USG may be an easy and reliable method which could be an alternative to urodynamic studies in patients who cannot undergo urethral catheterization.
Methods: Forty-five patients who were admitted to our institution between December 2012 and May 2013 and clinically and urodynamically diagnosed as having urinary incontinence (SUI n=20, DI+UUI n=13, MUI n=12) were included in the study. Additionally, 25 clinically and urodynamically continent women were included as the control group.
The patients were evaluated using transperineal ultrasonography (USG) in the supine position during rest and straining. An abdominal probe was placed in the perineum vertically and sagittally; when the symphysis pubis, urethra, bladder, vagina, and rectum could be seen clearly on the monitor, the image was frozen. Posterior urethrovesical angle (PUVA), urethral length, bladder wall thickness, and residual urine volume were measured on the image. All measurements were compared statistically between the SUI, UUI, MUI groups, and control group. The post-void residual volume measured using transperineal ultrasonography was compared with the post-void residual volume measured using a catheter during urodynamics.
Results: PUVA was significantly different in the SUI and MUI groups at rest than in the control group (p<0.05). During Valsalva maneuvers, PUVA was statistically significantly different in the SUI and MUI groups than in the UUI and control groups (p<0.01).
Conclusion: The measurement of PUVA and bladder wall thickness by transperineal ultrasonography is shown to be useful in diagnosis of patients with suspected detrusor instability and structural defects in pelvic floor. Therefore, transperineal USG may be an easy and reliable method which could be an alternative to urodynamic studies in patients who cannot undergo urethral catheterization.
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References
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