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Published online: 2023-03-02
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Could pelvic floor sonography be a standalone method for excluding genuine stress urinary incontinence in women?

Mariusz Malmur1, Jakub Mlodawski21, Marta Mlodawska2, Marcin Misiek3, Olga Adamczyk-Gruszka21, Piotr Niziurski21, Stanislaw Gluszek2, Wojciech Rokita†21
Affiliations
  1. Clinic of Obstetrics and Gynaecology, Provincial Combined Hospital in Kielce, Poland
  2. Collegium Medicum, Jan Kochanowski Univeristy, Kielce, Poland
  3. Department of Gynecologic Oncology, Holycross Cancer Center, Kielce, Poland, Poland

open access

Ahead of Print
ORIGINAL PAPERS Gynecology
Published online: 2023-03-02

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.

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Keywords

stress urinary incontinence; pelvic floor sonography; predictive models; logistic regression

Supp./Additional Files (4)
Figure 2. Measurement of gamma angle at rest
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Figure 3. Measurement of urethral lenght.
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Figure 4. Sign of urethral funneling
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Figure 5. ROC curve
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About this article
Title

Could pelvic floor sonography be a standalone method for excluding genuine stress urinary incontinence in women?

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2023-03-02

Page views

582

Article views/downloads

236

DOI

10.5603/GP.a2023.0026

Pubmed

36929790

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)
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