Skip to main content
Erschienen in: Journal of Medical Ultrasonics 1/2020

06.09.2019 | Original Article–Urology

Correlation of the type and degree of cystocele with stress urinary incontinence by transperineal ultrasound

verfasst von: Lan Bu, Dan Yang, Fang Nie, Qi Li, Yan-fang Wang

Erschienen in: Journal of Medical Ultrasonics | Ausgabe 1/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To assess the correlation between the type and degree of cystocele and stress urinary incontinence (SUI) by transperineal ultrasound.

Methods

A retrospective study evaluated 207 women who were diagnosed with cystocele by transperineal ultrasound. One hundred and six women who were diagnosed with SUI by a full urodynamic study were enrolled in the SUI group, 101 women without SUI were enrolled in the prolapse group, and 100 normal women with neither SUI nor POP were enrolled as the control group. In the transperineal ultrasound study, the bladder neck, the lowest point of the bladder wall, bladder neck funneling, the retrovesical angle, and the urethra inclination angle were observed at rest and Valsalva.

Results

It was found that 87.7% of patients in the SUI group were diagnosed with cystourethrocele, which was significantly higher than the 47.5% in the prolapse group. In addition, 93.4% of patients in the SUI group were diagnosed with Grade I or II cystocele and 6.6% were Grade III, which was significantly higher than that in the prolapse group. Bladder neck funneling on ultrasonography had a sensitivity of 59.4% and a specificity of 64.1% for the detection of SUI. It was significantly higher in cystourethrocele than isolated cystocele (P < 0.05).

Conclusion

The type and degree of cystocele can be diagnosed by transperineal ultrasound. Cystourethrocele and bladder neck funneling are highly correlated with SUI. Bladder neck funneling may be an important symptom of SUI.
Literatur
1.
Zurück zum Zitat Amaral MOP, Coutinho EC, Nelas PAAB, et al. Risk factors associated with urinary incontinence in Portugal and the quality of life of affected women. Int J Gynecol Obstet. 2015;131:82–6.CrossRef Amaral MOP, Coutinho EC, Nelas PAAB, et al. Risk factors associated with urinary incontinence in Portugal and the quality of life of affected women. Int J Gynecol Obstet. 2015;131:82–6.CrossRef
2.
Zurück zum Zitat Kalejaiye O, Vij M, Drake MJ. Classification of stress urinary incontinence. World J Urol. 2015;33:1215–20.CrossRef Kalejaiye O, Vij M, Drake MJ. Classification of stress urinary incontinence. World J Urol. 2015;33:1215–20.CrossRef
3.
Zurück zum Zitat Grzybowska ME, Wydra D, Smutek J. Analysis of the usage of continence pads and help-seeking behavior of women with stress urinary incontinence in Poland. BMC Womens Health. 2015;15:1–6.CrossRef Grzybowska ME, Wydra D, Smutek J. Analysis of the usage of continence pads and help-seeking behavior of women with stress urinary incontinence in Poland. BMC Womens Health. 2015;15:1–6.CrossRef
4.
Zurück zum Zitat Anil K, Lo TS, Khanuengkitkong S, et al. Diagnosis and conservative management of female stress urinary incontinence. Gynecol Minim Invasive Ther. 2013;2:48–51.CrossRef Anil K, Lo TS, Khanuengkitkong S, et al. Diagnosis and conservative management of female stress urinary incontinence. Gynecol Minim Invasive Ther. 2013;2:48–51.CrossRef
5.
Zurück zum Zitat Norton P, Brubaker L, Nager CW, et al. Pelvic organ prolapse in a cohort of women treated for stress urinary incontinence. Am J Obstet Gynecol. 2014;211:e1–5.CrossRef Norton P, Brubaker L, Nager CW, et al. Pelvic organ prolapse in a cohort of women treated for stress urinary incontinence. Am J Obstet Gynecol. 2014;211:e1–5.CrossRef
6.
Zurück zum Zitat Wu JM, Hundley AF, Fulton RG, et al. Forecasting the prevalence of pelvic floor disorders in US Women: 2010 to 2050. Obstet Gynecol. 2009;114:1278–83.CrossRef Wu JM, Hundley AF, Fulton RG, et al. Forecasting the prevalence of pelvic floor disorders in US Women: 2010 to 2050. Obstet Gynecol. 2009;114:1278–83.CrossRef
7.
Zurück zum Zitat Patel BN, Smith JJ, Badlani GH. Minimizing the cost of surgical correction of stress urinary incontinence and prolapse. Urology. 2009;74:762–4.CrossRef Patel BN, Smith JJ, Badlani GH. Minimizing the cost of surgical correction of stress urinary incontinence and prolapse. Urology. 2009;74:762–4.CrossRef
8.
Zurück zum Zitat Sherif H, Othman TS, Eldkhakhany A, et al. Transobturator four arms mesh in the surgical management of stress urinary incontinence with cystocele. Turk J Urol. 2017;43:517–24.CrossRef Sherif H, Othman TS, Eldkhakhany A, et al. Transobturator four arms mesh in the surgical management of stress urinary incontinence with cystocele. Turk J Urol. 2017;43:517–24.CrossRef
9.
Zurück zum Zitat Chantarasorn V, Dietz HP. Diagnosis of cystocele type by clinical examination and pelvic floor ultrasound. Ultrasound Obstet Gynecol. 2012;39:710–4.CrossRef Chantarasorn V, Dietz HP. Diagnosis of cystocele type by clinical examination and pelvic floor ultrasound. Ultrasound Obstet Gynecol. 2012;39:710–4.CrossRef
10.
Zurück zum Zitat Yang L, Qian SL, Yan LI, et al. Preliminary study of the diagnosis value in female bladder prolapse by transperineal four-dimensional ultrasound. J China Clin Med Imaging. 2015;26:585–8. Yang L, Qian SL, Yan LI, et al. Preliminary study of the diagnosis value in female bladder prolapse by transperineal four-dimensional ultrasound. J China Clin Med Imaging. 2015;26:585–8.
11.
Zurück zum Zitat Dietz HP. Ultrasound in the assessment of pelvic organ prolapse. Best Pract Res Clin Obstet Gynaecol. 2019;54:12–30.CrossRef Dietz HP. Ultrasound in the assessment of pelvic organ prolapse. Best Pract Res Clin Obstet Gynaecol. 2019;54:12–30.CrossRef
12.
Zurück zum Zitat Bump RC, Mattiasson A, Bø K, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;175:10–7.CrossRef Bump RC, Mattiasson A, Bø K, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;175:10–7.CrossRef
13.
Zurück zum Zitat Dietz HP, Hoyte LPJ, Steensma AB. Atlas of pelvic floor ultrasound. London: Springer; 2008.CrossRef Dietz HP, Hoyte LPJ, Steensma AB. Atlas of pelvic floor ultrasound. London: Springer; 2008.CrossRef
14.
Zurück zum Zitat Zhang G, Jiang W, Guo Q, et al. Value of UVJ-M in the diagnosis of SUI in late pregnancy and postpartum. Exp Ther Med. 2016;11:1772–6.CrossRef Zhang G, Jiang W, Guo Q, et al. Value of UVJ-M in the diagnosis of SUI in late pregnancy and postpartum. Exp Ther Med. 2016;11:1772–6.CrossRef
15.
Zurück zum Zitat Tomas K, Ulrich P, Graf CM, et al. Size does not make the difference: 3D/4D transperineal sonographic measurements of the female urethra in the assessment of urinary incontinence subtypes. Biomed Res Int. 2016;2016:1810352. Tomas K, Ulrich P, Graf CM, et al. Size does not make the difference: 3D/4D transperineal sonographic measurements of the female urethra in the assessment of urinary incontinence subtypes. Biomed Res Int. 2016;2016:1810352.
16.
Zurück zum Zitat Shek KL, Pirpiris A, Dietz HP. Does levator avulsion increase urethral mobility? Eur J Obstet Gynecol Reprod Biol. 2010;153:215–9.CrossRef Shek KL, Pirpiris A, Dietz HP. Does levator avulsion increase urethral mobility? Eur J Obstet Gynecol Reprod Biol. 2010;153:215–9.CrossRef
17.
Zurück zum Zitat Pirpiris A, Shek KL, Dietz HP. Urethral mobility and urinary incontinence. Ultrasound Obstet Gynecol. 2010;36:507–11 (The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology).CrossRef Pirpiris A, Shek KL, Dietz HP. Urethral mobility and urinary incontinence. Ultrasound Obstet Gynecol. 2010;36:507–11 (The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology).CrossRef
18.
Zurück zum Zitat Huang WC, Yang JM. Bladder neck funneling on ultrasound cystourethrography in primary stress urinary incontinence: a sign associated with urethral hypermobility and intrinsic sphincter deficiency. Urology. 2003;61:936–41.CrossRef Huang WC, Yang JM. Bladder neck funneling on ultrasound cystourethrography in primary stress urinary incontinence: a sign associated with urethral hypermobility and intrinsic sphincter deficiency. Urology. 2003;61:936–41.CrossRef
19.
Zurück zum Zitat González PÁL, López AIL, Cubillana PL, et al. Does cystocele have a role in bladder outlet obstruction? Actas Urol Esp. 2010;34:189–93.CrossRef González PÁL, López AIL, Cubillana PL, et al. Does cystocele have a role in bladder outlet obstruction? Actas Urol Esp. 2010;34:189–93.CrossRef
20.
Zurück zum Zitat Al-Saadi Ismail W. Transperineal ultrasonography in stress urinary incontinence: the significance of urethral rotation angles. Arab J Urol. 2016;14:66–71.CrossRef Al-Saadi Ismail W. Transperineal ultrasonography in stress urinary incontinence: the significance of urethral rotation angles. Arab J Urol. 2016;14:66–71.CrossRef
21.
Zurück zum Zitat Hickey DS, Hukins DW. Internal urinary sphincter in maintenance of female continence. BMJ. 1986;292:166–7.CrossRef Hickey DS, Hukins DW. Internal urinary sphincter in maintenance of female continence. BMJ. 1986;292:166–7.CrossRef
Metadaten
Titel
Correlation of the type and degree of cystocele with stress urinary incontinence by transperineal ultrasound
verfasst von
Lan Bu
Dan Yang
Fang Nie
Qi Li
Yan-fang Wang
Publikationsdatum
06.09.2019
Verlag
Springer Singapore
Erschienen in
Journal of Medical Ultrasonics / Ausgabe 1/2020
Print ISSN: 1346-4523
Elektronische ISSN: 1613-2254
DOI
https://doi.org/10.1007/s10396-019-00972-0

Weitere Artikel der Ausgabe 1/2020

Journal of Medical Ultrasonics 1/2020 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.