The Application Value Of Ultrasound In The Diagnosis Of Urethral Diseases In The Women

IntroductionWomen, especially older women have the problem about urine system, for example, Urinary frequency, urgency, dribbling urine and other symptoms. Because of no objective detection methods, most were misdiagnosed as urinary tract infection. Many reasons cause female urinary tract disorder, such as proliferation, neoplasm, abnormal channels, congenital disorders. Flexible fibre-urethro-cystoscope is an invasive check method for the female urethral disease, and gets single information; magnetic resonance imaging (MRI) is expensive and complicated to operate. Ultrasonography, especially transrectal ultrasonography can show the location of urethral lesions, source,the relationship of disease and urethral cavity spatial, and still can provide the lesion around urethra and other organs and tissues. It is pain-free, real-time economy, easy, and reproductive. In this study, ultrasonography would be applied in female urethral in diseases.Materials and Methods:Female patients were selected from May 2008 to January 2010 in Sichuan Provincial People's Hospital,in which 19 cases of stress urinary incontinence, and 36 cases of bladder neck obstruction, all were confirmed by surgical pathology and follow-up. Transabdominal. and transvaginal ultrasonography measured urethral length,diameter and the anteroposterior diameter of left and right of urethra, bladder point in quiet state, bladder point in stress state, bladder neck rotation and bladder neck to the pubic symphysis and bladder neck from the lower edge of distance down, residual urine volume, the thickness of the posterior lip of bladder neck. The results were analyzed with SPSS 13.0.Results:(1) There were significant difference (P<0.05) between SUI group and control group in the bladder neck to the lower margin of symphysis pubis distance, quiet state of the bladder point, the stress state of the bladder angles, or rotation in the bladder neck, bladder neck downward from the area. Clinical symptom severity was significantly positively correlated (P<0.05) with down from the bladder neck, bladder neck rotation and bladder neck to pubic symphysis the lower edge of distance. The quiet state of the bladder angles and the stress of the bladder angles and the clinical severity of symptoms did not show significant correlation (P> 0.05).(2) About residual urine volume≦12ml and≧ 50ml, the sensitivity of transabdominal and transvaginal ultrasonography diagnosis was no significant difference (p>0.05); residual urine volume in 13-49ml, the measured values of the sensitivity of the urethra within the population, significantly higher than after vaginal examination abdominal examination (p<0.05). Compared with the control group there were significant differences (p<0.05) in bladder neck obstruction group, about the bladder anterior, posterior lip of the thickness of the, around the track and around the bladder neck diameter. Residual urine volume with the bladder neck increases the severity of thickening. In bladder neck obstruction group, thickening level of the bladder neck (before or after lip lip thickening mainly) was positively correlated with age group (r=0.490, p=0.006).Conclusion:(1) The severity of stress urinary incontinence is significantly correlated with the distance of the bladder neck move down, the rotation angle of the bladder neck, the distance between bladder neck and the lower edge of pubic symphysis,which could reflect the activity of the bladder neck.(2) Increased residual urine, anterior or/and posterior lip of the bladder neck thickening> 3 mm, and inner processe to the bladder, or surpass the standard of the bladder neck diameter, anteroposterior diameter,it can be diagnosed as bladder neck obstruction with clinical symptoms.(3) Ultrasonography is obvious diagnostic value on a variety of female urethral diseases.