Visualized Urethral Mobility Profile During Urine Leakage in Supine and Standing Positions

Abstract

Objectives To describe the urethral course and position during urine leakage based on the visualized urethral mobility profile (UMP) and to explore the differences between supine and standing positions.

Method This was a prospective study of 100 women with SUI and 100 control women who underwent a cough stress test (CST) with transperineal ultrasound (TPUS) in supine and standing positions. In the mid-sagittal plane, the UMP software automatically placed six equidistant points from the bladder neck (point 1) to the external urethral meatus (point 6). It determined the x and y coordinates of the points relative to the symphysis pubis. The distance between the points and symphysis pubis (dist. 1 to 6) was calculated using the formula SQRT (x2 + y2). The visualized UMP was created by reproducing the six points on a bitmap.

Results Valid UMP data of 78 control women and 90 women with SUI were analyzed. In the two positions, distances 1 to 6 were significantly greater in the SUI group than the continent group (all p < 0.05). During Valsalva, the distance between the mid-urethra (dist. 3 and 4) and the symphysis was significantly increased (all p < 0.001) in the SUI group. The visualized UMP showed a similar upper-urethral course in the two groups. The gap between the mid-urethra (points 3 and 4) and symphysis was wider in the SUI group.

Conclusion The visualized UMP in supine and standing positions showed no difference in the bladder neck and upper urethral stability between incontinent and continent women, but mid-urethral stability was weaker in SUI.

Zusammenfassung

Ziel Beschreibung des Verlaufs und der Position der Harnröhre während des Harnverlusts anhand des visualisierten urethralen Mobilitätsprofils (UMP) und Untersuchung der Unterschiede zwischen Rückenlage und stehender Position.

Methode Es handelte sich um eine prospektive Studie mit 100 Frauen mit Stress-Harninkontinenz (SUI) und 100 Kontrollfrauen, die sich einem Husten-Stress-Test (HST) mit transperinealem Ultraschall (TPUS) in Rückenlage und im Stehen unterzogen. In der mittleren Sagittalebene platzierte die UMP-Software automatisch 6 äquidistante Punkte vom Blasenhals (Punkt 1) bis zum Meatus urethrae externus (Punkt 6). Sie bestimmte die x- und y-Koordinaten der Punkte relativ zur Symphysis pubica. Die Distanz zwischen den Punkten und der Symphysis pubica (Dist. 1 bis 6) wurde mit der Formel SQRT (x² + y²) berechnet. Das visualisierte UMP wurde durch die Wiedergabe der 6 Punkte auf einer Bitmap erstellt.

Ergebnisse Die validen UMP-Daten von 78 Kontrollfrauen und 90 Frauen mit SUI wurden analysiert. In den beiden Positionen waren die Distanzen 1 bis 6 in der SUI-Gruppe signifikant größer als in der Gruppe mit Kontinenz (alle p<0,05). Während des Valsalva-Manövers war der Abstand zwischen der mittleren Urethra (Dist. 3 und 4) und der Symphysis in der SUI-Gruppe signifikant vergrößert (alle p<0,001). Das visualisierte UMP zeigte in beiden Gruppen einen ähnlichen Verlauf der oberen Harnröhre. Die Distanz zwischen der mittleren Harnröhre (Punkte 3 und 4) und der Symphysis war in der SUI-Gruppe größer.

Schlussfolgerung Das visualisierte UMP in Rückenlage und im Stehen zeigte keinen Unterschied hinsichtlich der Stabilität des Blasenhalses und der oberen Harnröhre zwischen inkontinenten und kontinenten Frauen, aber bei SUI war die Stabilität der mittleren Harnröhre geringer.

Keywords

Urinary tract - Stress urinary incontinence - Pelvic floor ultrasound - Urethral mobility profile

Publication History

Received: 02 February 2021

Accepted after revision: 02 November 2021

Article published online:
15 February 2022

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