Department of Urology, The Sixth Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China.
Department of Urology, Yancheng Third People's Hospital, Yancheng, Jiangsu Province, China.
BMC Urol. 2023 Mar 27;23(1):44. doi: 10.1186/s12894-023-01220-x.
Perineal ultrasound as a non-invasive method for the diagnosis of female stress urinary incontinence has attracted more and more attention. However, the criteria for stress urinary incontinence in women using perineal ultrasound have not been fully established. Our study aimed to evaluate characteristics of the urethral spatial movement with perineal ultrasonography.
A total of 136 female patients with stress urinary incontinence and 44 controls were enrolled. Stress urinary incontinence was diagnosed using the International Consultation on Incontinence Questionnaire Short Form, medical history and physical examination, and severity was assessed using a 1 h pad test. We described the mobility of four equidistant points (A-D) located along the urethra length. The retrovesical and urethral rotation angles were measured using perineal ultrasonography at rest and during the maximal Valsalva maneuver.
Patients with stress urinary incontinence showed a more significant vertical movement at Points A, B and C than controls. The mean variations in the retrovesical angle were significantly larger in patients with stress urinary incontinence at rest and during the Valsalva maneuver than in controls (21.0 ± 16.5° vs. 14.7 ± 20.1°, respectively). The cut-off value for the retrovesical angle variation was 10.7° with 72% sensitivity and 54% specificity. There was a receiver-operating characteristic curve area of 0.73 and 0.72 for Points A and B, respectively. A cut-off of 10.8 mm, and 9.4 mm provided 71% sensitivity and 68% specificity and 67% sensitivity and 75% specificity, respectively.
The spatial movement of the bladder neck and proximal urethra, and variations in the retrovesical angle may be correlated with clinical symptoms and facilitate to the assessment of SUI.
经会阴超声作为一种非侵入性的女性压力性尿失禁诊断方法，越来越受到关注。然而，经会阴超声诊断女性压力性尿失禁的标准尚未完全确立。我们的研究旨在评估经会阴超声检查时尿道空间运动的特征。
共纳入 136 例压力性尿失禁女性患者和 44 例对照。压力性尿失禁采用国际尿失禁咨询问卷短表、病史和体格检查进行诊断，并采用 1 h 垫试验进行严重程度评估。我们描述了沿尿道长度等距的 4 个点（A-D）的活动度。在静息和最大瓦氏动作时，经会阴超声测量膀胱后角和尿道旋转角度。
压力性尿失禁患者在 A、B 和 C 点的垂直运动幅度明显大于对照组。在静息和瓦氏动作时，压力性尿失禁患者的膀胱后角变化均值明显大于对照组（分别为 21.0 ± 16.5°和 14.7 ± 20.1°）。膀胱后角变化的截断值为 10.7°，其敏感性为 72%，特异性为 54%。A 点和 B 点的受试者工作特征曲线面积分别为 0.73 和 0.72。截断值为 10.8mm 和 9.4mm 时，敏感性分别为 71%和 68%，特异性分别为 68%和 75%。
膀胱颈和近端尿道的空间运动以及膀胱后角的变化可能与临床症状相关，有助于评估 SUI。
