[Application of transperineal pelvic floor ultrasonography in the diagnosis of female stress urinary incontinence]

Zhonghua Yi Xue Za Zhi. 2018 Sep 4;98(33):2675-2677. doi: 10.3760/cma.j.issn.0376-2491.2018.33.013.
[Article in Chinese]

Abstract

Objective: To explore the application of transperineal pelvic floor ultrasonography in the diagnosis of female stress urinary incontinence(SUI). Methods: From March 2017 to December 2017, 60 patients diagnosed with SUI by department of gynecology, Xiangya Hospital of Central South University were selected as the case group, and 30 cases of normal women in the same period were selected as the control group. All subjects in both groups were examined by transperineal pelvic floor ultrasonography, that is, to be measured the bladder neck descent(BND), the urethral inclination angle(UIA), the posterior urethrovesical angle(PUVA) and the levator hiatus area(LHA) in resting state and during Valsalva maneuver. Results: (1)The differences in the measured values of the two groups were statistically significant(P<0.05). (2)The receiver operating characteristic curve(ROC) was used to find the cut-off values of SUI: when BND>31.5 mm; in Valsalva state, UIA>33.5°, PUVA>150.5° and LHA>20.6 cm2, with their sensitivity of 77.6%, 71.4%, 68.3% and 61.4%, respectively; the specificity of 68.9%, 74.6%, 73.9% and 78.0%, respectively. The area under the curve(AUC) were 0.753, 0.812, 0.721 and 0.712, respectively, when combined analysis of these indexes, reaching to 0.912. Conclusions: (1) Transperineal pelvic floor ultrasonography has a certain diagnostic value for SUI. (2)Combined analysis of various ultrasonic parameters can significantly improve the diagnostic efficiency of SUI.

目的: 研究经会阴盆底超声在女性压力性尿失禁(SUI)诊断中的价值。 方法: 选取2017年3至12月中南大学湘雅医院妇科门诊及住院部诊断为SUI患者60例为病例组,选取同期正常妇女30例为对照组。两组经会阴盆底超声检查,即在静息状态及最大Valsalva动作下,检测膀胱颈移动度(BND)、尿道倾斜角(UIA)、膀胱尿道后角(PUVA)、肛提肌裂孔面积(LHA)。 结果: (1)两组测值差异均有统计学意义(均P<0.05)。(2)绘制受试者工作特性曲线(ROC),寻找各参数的截断值:BND>31.5 mm,最大Valsalva动作下UIA>33.5°、PUVA>150.5°、LHA>20.6 cm2,敏感度分别为77.6%、71.4%、68.3%、61.4%,特异度分别为68.9%、74.6%、73.9%、78.0%。以上4种参数曲线下面积(AUC)分别为0.753、0.812、0.721、0.712;4种参数联合分析时AUC为0.912。 结论: (1)经会阴盆底超声对SUI具有一定诊断价值。(2)多种超声参数联合分析,能明显提高对SUI的诊断效能。.

Keywords: Pelvic floor; Ultrasonography; Urethra; Urinary incontinence.

MeSH terms

  • Female
  • Humans
  • Pelvic Floor
  • Ultrasonography
  • Urethra
  • Urinary Incontinence, Stress / diagnostic imaging*