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Three‐dimensional translabial ultrasound assessment of urethral supports and the urethral sphincter complex in stress urinary incontinence
Author(s) -
Cassadó Garriga Jordi,
Pessarrodona Isern Antoni,
Rodríguez Carballeira Monica,
Pallarols Badia Mar,
Moya del Corral Manuela,
Valls Esteve Marta,
Huguet Galofré Eva
Publication year - 2017
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23193
Subject(s) - medicine , urinary incontinence , urology , stress incontinence , urethra , ultrasound , valsalva maneuver , pelvic floor , urethral sphincter , urogynecology , neck of urinary bladder , gynecology , surgery , urinary bladder , radiology , blood pressure
Aims The pathophysiological mechanism of incontinence is multifactorial. We evaluated the role of 3D‐4D ultrasound in the assessment of the fascial supports of the urethra and the urethral sphincter complex (USC) for diagnosing stress urinary incontinence. Methods Observational case‐control study in women with and without stress urinary incontinence attending a urogynecology service and a general gynecology service. All women were interviewed, examined, and classified according to the Pelvic Organ Prolapse Quantification (POP‐Q) and underwent a 3D‐4D translabial ultrasound. Fascial supports of the urethra were assessed by tomographic ultrasound and were considered to be intact or absent if it was possible to identify them at eight levels on each side, urethral mobility was assessed on maximal Valsalva in sagittal section and the length and volume of the USC at rest and on maximal Valsalva were determined using the Virtual Organ Computer‐aided Analysis (VOCAL) program. Variables were compared between continent and incontinent women. Results A total of 173 women were examined, 78 continent and 95 incontinent. There was a significant difference in urethral mobility between continent and incontinent women (12.82 mm vs. 21.85 mm, P < 0.001), but there was no significant difference in the percentage of supports affected (43.27% vs. 35.94%, P < 0.070). The length of the USC at rest was significantly shorter ( P < 0.001) in incontinent patients. Conclusions Ultrasound evaluation of urethral supports does not discriminate between continent and incontinent women. However, the length of the USC at rest was shorter and urethral mobility was higher in incontinent women. Neurourol. Urodynam. 9999:XX–XX, 2016 . © 2016 Wiley Periodicals, Inc.