Association of urinary and anal incontinence with measures of pelvic floor muscle contractility

Objective To assess the association between clinical and sonographic measures of pelvic floor muscle ( PFM ) function and symptoms of urinary and anal incontinence ( AI ). Methods This was a retrospective study of women seen at a tertiary urogynecological unit. All women had undergone a standardized interview, clinical examination including Modified Oxford Scale ( MOS ) grading, urodynamic testing and four‐dimensional translabial ultrasound ( TLUS ). Cranioventral shift of the bladder neck ( BN ) and reduction in the hiatal anteroposterior ( AP ) diameter were measured using ultrasound volumes acquired on maximal PFM contraction, blinded against all clinical data. Results Data from 726 women with a mean age of 56 ± 13.7 (range, 18–88) years and a mean body mass index of 29 ± 6.1 (range, 17–55) kg/m 2 were analyzed. Stress ( SI ) and urge ( UI ) urinary incontinence were reported by 73% and 72%, respectively, and 13% had AI . Mean MOS grade was 2.4 ± 1.1 (range, 0–5). Mean cranioventral BN shift on TLUS was 7.1 ± 4.4 (range, 0.3–25.3) mm; mean reduction in AP hiatal diameter was 8.6 ± 4.8 (range, 0.3–31.3) mm. On univariate analysis, neither MOS nor TLUS measures were strongly associated with symptoms of urinary incontinence or AI ; associations were non‐significant except for BN displacement/ SI (7.3 mm vs 6.5 mm; P = 0.028), BN displacement/ UI (6.85 vs 7.75; P = 0.019), hiatal AP diameter/ AI (9.6 mm vs 8.5 mm; P = 0.047) and MOS / SI (2.42 vs 2.19; P = 0.013). Conclusions In this large retrospective study we did not find any strong associations between sonographic or palpatory measures of PFM function and symptoms of urinary incontinence or AI . Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.