Vol 94, No 5 (2023)
Research paper
Published online: 2022-09-07
Ultrasound imaging of abdominal muscles activity among women with stress urinary incontinence: case-control study in Poland
1
, 2, 31, 4, 5, 6
, 2, 31, 4, 5, 6
Abstract
Objectives: The aim of the present study is the assessment of thickness and percentage change in thickness of the musculus obliquus externus abdominis (OE), musculus obliquus internus abdominis (OI) and musculus transversus abdominis (TrA) among women suffering from stress urinary incontinence (SUI) in comparison with healthy controls. Material and methods: The thickness and its percentage changes of the OE, OI and TrA among women with and without SUI were assessed. We observed the reactions of the abdominal muscles among 84 women by means of ultrasound imaging. Results: The thickness of the OE was significantly greater in the SUI group during rest and tension of the lower part of the abdomen. Significant changes were found in the OI for the controls during isometric tension of the abdominal muscles, tension of the lower part of the abdomen, and ASLR (active straight leg raise) test of right leg. The thickness changes in the TrA were significant for the controls during isometric tension of the abdominal muscles. Conclusions: Our results suggest interactions of the pelvic floor and the abdominal muscles during pelvic floor activity, differing in the women with SUI and controls.
Keywords: stress urinary incontinencepelvic floor musclesultrasound imagingabdominal muscles
References
- Haylen BT, de Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010; 21(1): 5–26.
- Nambiar AK, Arlandis S, Bø K, et al. European Association of Urology guidelines on the diagnosis and management of female non-neurogenic lower urinary tract symptoms. Part 1: Diagnostics, overactive bladder, stress urinary incontinence, and mixed urinary incontinence. Eur Urol. 2022; 82(1): 49–59.
- Wlazlak E, Grzybowska ME, Rechberger T, et al. The Urogynecology Section of the Polish Society of Gynecologists and Obstetricians Guideline for the diagnostic assessment of stress urinary incontinence in women. Ginekol Pol. 2022 [Epub ahead of print].
- Stangel-Wojcikiewicz K, Rogowski A, Rechberger T, et al. Urogynecology Section of the Polish Society of Gynecologists and Obstetricians guidelines on the management of stress urinary incontinence in women. Ginekol Pol. 2021; 92(11): 822–828.
- Falah-Hassani K, Reeves J, Shiri R, et al. The pathophysiology of stress urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J. 2021; 32(3): 501–552.
- Neumann P, Gill V. Pelvic floor and abdominal muscle interaction: EMG activity and intra-abdominal pressure. Int Urogynecol J Pelvic Floor Dysfunct. 2002; 13(2): 125–132.
- Ferla L, Darski C, Paiva L, et al. Synergism between abdominal and pelvic floor muscles in healthy women: a systematic review of observational studies. Fisioter Mov. 2016; 29(2): 399–410.
- Vesentini G, El Dib R, Righesso LA, et al. Pelvic floor and abdominal muscle cocontraction in women with and without pelvic floor dysfunction: a systematic review and meta-analysis. Clinics (Sao Paulo). 2019; 74: e1319.
- Park SY, Oh S, Baek KH, et al. Comparison of abdominal muscle thickness between the abdominal draw-in maneuver and maximum abdominal contraction maneuver. Healthcare (Basel). 2022; 10(2).
- Zachovajeviene B, Siupsinskas L, Zachovajevas P, et al. Effect of diaphragm and abdominal muscle training on pelvic floor strength and endurance: results of a prospective randomized trial. Sci Rep. 2019; 9(1): 19192.
- Sapsford RR, Hodges PW, Richardson CA, et al. Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourol Urodyn. 2001; 20(1): 31–42, doi: 10.1002/1520-6777(2001)20:1<31::aid-nau5>3.0.co;2-p.
- Madill SJ, McLean L. Relationship between abdominal and pelvic floor muscle activation and intravaginal pressure during pelvic floor muscle contractions in healthy continent women. Neurourol Urodyn. 2006; 25(7): 722–730.
- Tajiri K, Huo M, Maruyama H. Effects of co-contraction of both transverse abdominal muscle and pelvic floor muscle exercises for stress urinary incontinence: a randomized controlled trial. J Phys Ther Sci. 2014; 26(8): 1161–1163.
- Tajiri K, Huo M, Yin Ke, et al. An approach to assessment of female urinary incontinence risk using the thickness of the transverse abdominal muscle during co-contraction of both the transverse abdominal muscle and the pelvic floor muscle. J Phys Ther Sci. 2011; 23(1): 45–48.
- Arab AM, Chehrehrazi M. The response of the abdominal muscles to pelvic floor muscle contraction in women with and without stress urinary incontinence using ultrasound imaging. Neurourol Urodyn. 2011; 30(1): 117–120.
- Stamey TA. Endoscopic suspension of the vesical neck for urinary incontinence in females. Report on 203 consecutive patients. Ann Surg. 1980; 192(4): 465–471.
- Burzynski B, Jurys T, Knapik M, et al. Abdominal complex muscle in women with stress urinary incontinence – prospective case-control study. Archives of Medical Science. 2021.
- Chang WJ. Active straight leg raise. J Physiother. 2012; 58(2): 132.
- Hodges PW, Pengel LHM, Herbert RD, et al. Measurement of muscle contraction with ultrasound imaging. Muscle Nerve. 2003; 27(6): 682–692.
- Adams L, Pace N, Heo A, et al. Internal and external oblique muscle asymmetry in sprint hurdlers and sprinters: a cross-sectional study. J Sports Sci Med. 2022; 21(1): 120–126.
- Madokoro S, Miaki H. Relationship between transversus abdominis muscle thickness and urinary incontinence in females at 2 months postpartum. J Phys Ther Sci. 2019; 31(1): 108–111.
- Gibbon KC, Debuse D, Hibbs A, et al. Reliability and precision of sonography of the lumbar multifidus and transversus abdominis during dynamic activities. J Ultrasound Med. 2017; 36(3): 571–581.
- Sánchez Romero EA, Alonso Pérez JL, Muñoz Fernández AC, et al. Reliability of sonography measures of the lumbar multifidus and transversus abdominis during static and dynamic activities in subjects with non-specific chronic low back pain. Diagnostics (Basel). 2021; 11(4).
- Gnat R, Saulicz E, Miądowicz B. Reliability of real-time ultrasound measurement of transversus abdominis thickness in healthy trained subjects. Eur Spine J. 2012; 21(8): 1508–1515.
- Luczynska E, Zbigniew K. Diagnostic imaging in gynecology. Ginekol Pol. 2022 [Epub ahead of print].
- Figueiredo VF, Amorim JSC, Pereira AM, et al. Associations between low back pain, urinary incontinence, and abdominal muscle recruitment as assessed via ultrasonography in the elderly. Braz J Phys Ther. 2015; 19(1): 70–76.
