Background/Objectives: To investigate the utility of transperineal ultrasound in detecting stress urinary incontinence (SUI) and identify optimal anatomical and functional parameters. Methods: Thirty-four women presenting with SUI with or without pelvic organ prolapse between 2012 and 2016 were studied. The control group included patients without SUI who underwent surgery for mild gynecologic disorders or pelvic organ prolapse. The relationship between selected ultrasound parameters and SUI was determined. Results: Among the 20 variables measured in ultrasonography using 4 angles and the bladder-symphysis distance (BSD) values, we found that the difference in the BSD obtained at rest and during the Valsalva maneuver (odds ratio [OR]: 1.15, 95% confidence interval [CI]: 1.05-1.27, p = 0.004), the mean urethral diameter (UD; OR: 4.29, 95% CI: 2.07-8.83, p = 0.0001), and the occurrence of the funneling sign during the Valsalva maneuver (OR: 21; 95% CI: 6.1-71.9, p < 0.0001) were associated with urinary incontinence in the logistic regression analysis. The optimal cut-off point for BSD was >8 mm (area under the curve (AUC), 0.71; sensitivity, 91.2%; specificity, 56.8%; p = 0.001) and that for UD was >6 mm (AUC, 0.84; sensitivity, 82.1%; specificity, 73%; p < 0.001). Conclusions: Transperineal ultrasonography is a useful tool for detecting SUI. Our findings highlighted the utility of several sonographic parameters, mainly the urethral diameter, in the diagnosis of urinary incontinence.
Diagnostics (Basel, Switzerland). 2024 Nov 14*** epublish ***
Milosz Pietrus, Kazimierz Pityński, Maciej W Socha, Iwona Gawron, Robert Biskupski-Brawura-Samaha, Marcin Waligóra
Department of Gynecology and Oncology, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Kraków, Poland., Department of Perinatology, Gynecology and Gynecologic Oncology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 85-821 Bydgoszcz, Poland., Clinic of Gynecological Endocrinology, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Kraków, Poland., Department of Obstetrics, Perinatology and Neonatology, Center for Postgraduate Medical Education, Marymoncka St. 99/103, 01-813 Warsaw, Poland., Pulmonary Circulation Centre, Department of Cardiac and Vascular Diseases, Faculty of Medicine, Jagiellonian University Medical College, John Paul II Hospital in Kraków, 31-022 Kraków, Poland.