Study On Stress Urinary Incontinence And Cystocele Type By Transperineal Ultrasonography

PurposeThe purpose of this study was to discuss the expression of transperineal ultrasonography in the patient of stress urinary incontinent,study the meaning of various parameters of transperineal ultrasonography,especially bladder neck funneling and intrinsic urethral sphincter deficiency(ISD)in women with stress urinary incontinent.At the same time,this study was to evaluate the different type of cystocele by transperineal ultrasonography,and to investigate the correlation of stress urinary incontinence and cystocele type.Materials and MethodsFirst of all,collect the basic information of female patients that confirmed stress urinary incontinence or pelvic prolapse by clinical or urine dynamics,including age,height,weight,family history,history of menopause,postpartum rehabilitation training history,heavy manual labor history,clinical symptoms were analyzed.It can be divided into stress urinary incontinence group,bladder prolapse group,a retrospective study evaluated for the ultrasound parameters each group of patients.The bladder wall thickness,the bladder neck and bladder back wall lowest point,the posterior urethrovesical angle(PUA),the urethra inclination angle were observed by transperineal ultrasound at rest and Valsalva,and the bladder neck decent,bladder back wall lowest point decent and urethral rotation angle were calculated.The urethral diameter was measured at rest.To observe the driversification of pelvic morphology and structure,and the area of levator hiatua was measured in real-time three-dimensional ultrasound mode.Normal women was the control groupResults(1)The rate of bladder neck funneling in women with SUI was 66%,and it was greater than continent women 5%.(2)Women with SUI showed significantly greater bladder neck descent and greater PUA than continent women(P<0.05).(3)There were 9 with ISD in SUI that confirmed by urodynamic study had bladder neck funneling,the urethral diameter of women with ISD showed no significantly statistical significance than women without ISD and control women,P>0.05.(4)73 was diagnosed cystourethrocele and 10 was diagnosed isolated cystocele in Group SUI,and 37 was diagnosed cystourethrocele and 41 was diagnosed isolated cystocele in Group cystocele by transperineal ultrasound,the difference was statistically significant(P<0.05).(5)The bladder neck descent was no difference in cystourethrocele and isolated cystocele(P>0.05),but bladder back wall lowest point,PUA and urethral rotation angle were statistically significant(P<0.05).(6)All the parameters were statistically significant after Valsalva when compared between Group SUI,Group cystocele and control group(P<0.05).Conclusions(1)The perineal 2D and real-time 3D ultrasound technologies provide economical,simple and practical imaging methods for evaluating pelvic floor structure and anatomy of patients with SUI or cystocele type.(2)The various parameters of transperineal ultrasonography including the bladder neck decent,bladder back wall lowest point decent,the posterior urethrovesical angle(PUA),urethral rotation angle had guiding significance in assessing SUI and cystocele type.(3)Bladder neck funneling had an important role in stress urinary incontinence,and it was closely related to the supporting structures of bladder neck and ISD.But it is need further study to assessment ISD by measuring urethral diameter.(4)Cystocele type can been diagnosed by transperineal ultrasound.Different cystocele type had different pelvic floor anatomy,and cystourethrocele was closely related to SUI.