Peker Hakan, Haliloglu Peker Berna
Vocational School of Health, Nisantasi University, Maslak Mahallesi, Tasyoncası Sokak, No: 1V ve No:1Y Sariyer, Istanbul, Turkey.
Department of Obstetrics&Gynecology, Maltepe University Faculty of Medicine, Ataturk Caddesi, Cam Sokak. No:3/A 34843 Maltepe, Istanbul, Turkey.
Eur J Obstet Gynecol Reprod Biol. 2021 Jun;261:148-153. doi: 10.1016/j.ejogrb.2021.04.037. Epub 2021 Apr 27.
We aimed to compare the morphological characteristics of pelvis and urethra in nulliparous pregnant women with and without stress urinary incontinence (SUI) by 3D high-frequency endovaginal ultrasound (3D-EVUS).
At 36-38 weeks of gestation, 40 nulliparous pregnant women with and without SUI underwent 3D-EVUS assessment. The anteroposterior and transverse diameters of levator hiatus (LH), pubovisceral muscle thicknesses at 3,9 and 12 o'clock, right and left paravaginal areas, symphysis angle, bladder-symphysis distance (BSD), uretral complex thickness (Ut), urethral complex width (Uw), urethral complex volume (UV), urethral length (UL), intramural urethra, rhabdosphincter thickness (Rt), rhabdosphincter width (Rw), rhabdosphincter length (RL), and rhabdosphincter volume (RV) were measured by 3D-EVUS.
Longer LH transverse diameter (34.8 ± 3.8 mm vs 31.1 ± 2.1 mm), shorter LH anteroposterior diameter (47.8 ± 6.2 mm vs 52.4 ± 2.6 mm), and wider symphysis angle (116.3 ± 5.6 vs 111.5 ± 5.3 degrees) were detected in nulliparous pregnant women with SUI compared those without SUI (p = 0.001, p = 0.001 and p = 0.013; respectively). RV of less than 1.26 cm was found to have a sensitivity of 100 % and a specificity of 100 % for the presence of SUI in nulliparous pregnant women.
Constitutionally different pelvic shape and decreased urethral rhabdosphincter measurements can be used to predict SUI in nulliparous pregnant women.
我们旨在通过三维高频经阴道超声（3D-EVUS）比较有无压力性尿失禁（SUI）的未孕孕妇骨盆和尿道的形态学特征。
在妊娠36 - 38周时，40名有无SUI的未孕孕妇接受了3D-EVUS评估。通过3D-EVUS测量提肛裂孔（LH）的前后径和横径、耻骨内脏肌在3点、9点和12点处的厚度、左右阴道旁区域、耻骨联合角、膀胱-耻骨联合距离（BSD）、尿道复合体厚度（Ut）、尿道复合体宽度（Uw）、尿道复合体体积（UV）、尿道长度（UL）、壁内尿道、横纹括约肌厚度（Rt）、横纹括约肌宽度（Rw）、横纹括约肌长度（RL）和横纹括约肌体积（RV）。
与无SUI的未孕孕妇相比，有SUI的未孕孕妇LH横径更长（34.8±3.8mm对31.1±2.1mm），LH前后径更短（47.8±6.2mm对52.4±2.6mm），耻骨联合角更宽（116.3±5.6对111.5±5.3度）（分别为p = 0.001、p = 0.001和p = 0.013）。发现RV小于1.26cm对未孕孕妇SUI的存在具有100%的敏感性和100%的特异性。
先天性不同的骨盆形状和尿道横纹括约肌测量值降低可用于预测未孕孕妇的SUI。
