open access
Could pelvic floor sonography be a standalone method for excluding genuine stress urinary incontinence in women?
Affiliations- Clinic of Obstetrics and Gynaecology, Provincial Combined Hospital in Kielce, Poland
- Collegium Medicum, Jan Kochanowski Univeristy, Kielce, Poland
- Department of Gynecologic Oncology, Holycross Cancer Center, Kielce, Poland, Poland
open access
Abstract
Objectives: Determine whether introital pelvic floor sonography with transvaginal probe (PFS-TV) can be an independent method in the diagnosis of genuine stress urinary incontinence (SUI) and to create a ultrasonographic diagnostic model to objectify diagnostic process. Material and methods: The study involved 315 patients with a history of urinary incontinence problems. Based on the clinical examination and urodynamic examination, the final diagnosis was made. Patients were divided into two groups. Group I included women with SUI and Group II included patients without SUI (OAB and no-UI). Each patient underwent PFS-TV at rest and during straining. The groups were compared in terms of ultrasound parameters. Results: Patients from both groups differed statistically in a significant way (p < 0.05) in terms of mean distance between the lower edge of the pubic symphysis at rest 19 mm vs 22 mm (Group I vs Group II) and during straining (D1 and D2) 22 mm vs 26 mm, the average value of the γ angle (at rest (γ1) 37.5° vs 40° and during straining (γ2) and 66° vs 58.5°, average difference value of angle γ during straining and at rest (γ2−γ1) 29° vs 14°, and frequency of urethral funneling 89% vs 17%. Two parameters studied during PFS-TV were included in the logistic regression model used to exclude the stress component of urinary incontinence. Diagnostic test parameters of model were sensitivity 86.6%, specificity 90.4%, accuracy 93.1%. Conclusions: PFS-TV makes it possible to exclude the stress component of urinary incontinence. The developed logistic regression model allows for the objectification of the results of ultrasound examination in patients with urinary incontinence.
Abstract
Objectives: Determine whether introital pelvic floor sonography with transvaginal probe (PFS-TV) can be an independent method in the diagnosis of genuine stress urinary incontinence (SUI) and to create a ultrasonographic diagnostic model to objectify diagnostic process. Material and methods: The study involved 315 patients with a history of urinary incontinence problems. Based on the clinical examination and urodynamic examination, the final diagnosis was made. Patients were divided into two groups. Group I included women with SUI and Group II included patients without SUI (OAB and no-UI). Each patient underwent PFS-TV at rest and during straining. The groups were compared in terms of ultrasound parameters. Results: Patients from both groups differed statistically in a significant way (p < 0.05) in terms of mean distance between the lower edge of the pubic symphysis at rest 19 mm vs 22 mm (Group I vs Group II) and during straining (D1 and D2) 22 mm vs 26 mm, the average value of the γ angle (at rest (γ1) 37.5° vs 40° and during straining (γ2) and 66° vs 58.5°, average difference value of angle γ during straining and at rest (γ2−γ1) 29° vs 14°, and frequency of urethral funneling 89% vs 17%. Two parameters studied during PFS-TV were included in the logistic regression model used to exclude the stress component of urinary incontinence. Diagnostic test parameters of model were sensitivity 86.6%, specificity 90.4%, accuracy 93.1%. Conclusions: PFS-TV makes it possible to exclude the stress component of urinary incontinence. The developed logistic regression model allows for the objectification of the results of ultrasound examination in patients with urinary incontinence.
Keywords
stress urinary incontinence; pelvic floor sonography; predictive models; logistic regression
Supp./Additional Files (4)
About this articleTitle
Could pelvic floor sonography be a standalone method for excluding genuine stress urinary incontinence in women?
Journal
Issue
Article type
Research paper
Published online
2023-03-02
Page views
19
Article views/downloads
19
DOI
10.5603/GP.a2023.0026
Pubmed
Keywords
stress urinary incontinence
pelvic floor sonography
predictive models
logistic regression
Authors
Mariusz Malmur
Jakub Mlodawski
Marta Mlodawska
Marcin Misiek
Olga Adamczyk-Gruszka
Piotr Niziurski
Stanislaw Gluszek
Wojciech Rokita†
References (12)- Minassian VA, Yan X, Lichtenfeld MJ, et al. The iceberg of health care utilization in women with urinary incontinence. Int Urogynecol J. 2012; 23(8): 1087–1093.
- Girum T, Muktar E, Shegaze M. Determinants of life expectancy in low and medium human development index countries. Medical Studies. 2018; 34(3): 218–225.
- Fabian G, Kociszewski J, Kuszka A, et al. Vaginal excision of the sub-urethral sling: analysis of indications, safety and outcome. Arch Med Sci. 2015; 11(5): 982–988.
- Tunn R, Albrich S, Beilecke K, et al. Interdisciplinary S2k Guideline: Sonography in Urogynecology: Short Version - AWMF Registry Number: 015/055. Geburtshilfe Frauenheilkd. 2014; 74(12): 1093–1098.
- Xiao T, Chen Y, Gan Y, et al. Can Stress Urinary Incontinence Be Predicted by Ultrasound? AJR Am J Roentgenol. 2019; 213(5): 1163–1169.
- Wlaźlak E, Kluz T, Surkont G, et al. Urethral funneling visualized during pelvic floor sonography - analysis of occurrence among urogynecological patients. Ginekol Pol. 2018; 89(2): 55–61.
- Versi E. The significance of an open bladder neck in women. Br J Urol. 1991; 68(1): 42–43.
- Brubaker L, Cundiff GW, Fine P, et al. Pelvic Floor Disorders Network. Abdominal sacrocolpopexy with Burch colposuspension to reduce urinary stress incontinence. N Engl J Med. 2006; 354(15): 1557–1566.
- Dietz HP, Eldridge A, Grace M, et al. Test–retest reliability ofthe ultrasound assessment of bladder neck mobility. Int Urogynecol J. 2003; 14(S1): S57–S58.
- Wlaźlak E, Kluz T, Kociszewski J, et al. The analysis of repeatability and reproducibility of bladder neck mobility measurements obtained during pelvic floor sonography performed introitally with 2D transvaginal probe. Ginekol Pol. 2017; 88(7): 360–365.
- Pomian A, Majkusiak W, Kociszewski J, et al. Demographic features of female urethra length. Neurourol Urodyn. 2018; 37(5): 1751–1756.
- Ulmsten U, Henriksson L, Johnson P, et al. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 1996; 7(2): 81–5; discussion 85.
