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Ultrasound Characteristics of Patients with Urinary Stress Incontinence with or without Genital Prolapse

PURPOSE: The study purpose was to evaluate the clinical and ultrasound characteristics of women with urinary stress incontinence (USI) with or without genital prolapse (GP). MATERIALS AND METHODS: A total of 268 patients who underwent ultrasound perineal evaluation were divided into two groups: isol...

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Autor principal: Antovska, Vesna S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Urological Association 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3490089/
https://www.ncbi.nlm.nih.gov/pubmed/23136629
http://dx.doi.org/10.4111/kju.2012.53.10.691
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author Antovska, Vesna S.
author_facet Antovska, Vesna S.
author_sort Antovska, Vesna S.
collection PubMed
description PURPOSE: The study purpose was to evaluate the clinical and ultrasound characteristics of women with urinary stress incontinence (USI) with or without genital prolapse (GP). MATERIALS AND METHODS: A total of 268 patients who underwent ultrasound perineal evaluation were divided into two groups: isolated USI (n=132) and USIGP (n=136) with USI/GP stage I/II. The latter group was additionally divided into two subgroups: USIGP(A) (n=78) with USI/GP stage I and USIGP(B) (n=58) with USI/GP stage II. RESULTS: Point Aa (pelvic organ prolapse quantification system), which is the projection of the bladder neck (BN) on the anterior vaginal wall, was situated higher in the rest position (RP) but moved lower during a Valsalva maneuver (VM) in the USI group than in the USIGP group (p<0.05). The ultrasound parameters α-angle and the distance Sy-BN (symphisis-bladder neck) decreased, whereas distance H increased, in the USIGP group during VM. The ultrasound parameters that gave the best insight into the range of BN movements were as follows: distance R→V and angle of rotation (ρ), which were significantly higher in the USI group than in the USIGP group during VM. CONCLUSIONS: According to the clinical and ultrasound findings, we can conclude that the BN is situated higher during the RP but moved lower during a VM in patients with isolated USI compared with those with concomitant USI/GP, which could be explained by the cystocele-immobilizing effect on the BN during the VM in the latter group but also by the deteriorated pubo-urethral ligaments in the former group.
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spelling pubmed-34900892012-11-07 Ultrasound Characteristics of Patients with Urinary Stress Incontinence with or without Genital Prolapse Antovska, Vesna S. Korean J Urol Original Article PURPOSE: The study purpose was to evaluate the clinical and ultrasound characteristics of women with urinary stress incontinence (USI) with or without genital prolapse (GP). MATERIALS AND METHODS: A total of 268 patients who underwent ultrasound perineal evaluation were divided into two groups: isolated USI (n=132) and USIGP (n=136) with USI/GP stage I/II. The latter group was additionally divided into two subgroups: USIGP(A) (n=78) with USI/GP stage I and USIGP(B) (n=58) with USI/GP stage II. RESULTS: Point Aa (pelvic organ prolapse quantification system), which is the projection of the bladder neck (BN) on the anterior vaginal wall, was situated higher in the rest position (RP) but moved lower during a Valsalva maneuver (VM) in the USI group than in the USIGP group (p<0.05). The ultrasound parameters α-angle and the distance Sy-BN (symphisis-bladder neck) decreased, whereas distance H increased, in the USIGP group during VM. The ultrasound parameters that gave the best insight into the range of BN movements were as follows: distance R→V and angle of rotation (ρ), which were significantly higher in the USI group than in the USIGP group during VM. CONCLUSIONS: According to the clinical and ultrasound findings, we can conclude that the BN is situated higher during the RP but moved lower during a VM in patients with isolated USI compared with those with concomitant USI/GP, which could be explained by the cystocele-immobilizing effect on the BN during the VM in the latter group but also by the deteriorated pubo-urethral ligaments in the former group. The Korean Urological Association 2012-10 2012-10-19 /pmc/articles/PMC3490089/ /pubmed/23136629 http://dx.doi.org/10.4111/kju.2012.53.10.691 Text en © The Korean Urological Association, 2012 http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Antovska, Vesna S.
Ultrasound Characteristics of Patients with Urinary Stress Incontinence with or without Genital Prolapse
title Ultrasound Characteristics of Patients with Urinary Stress Incontinence with or without Genital Prolapse
title_full Ultrasound Characteristics of Patients with Urinary Stress Incontinence with or without Genital Prolapse
title_fullStr Ultrasound Characteristics of Patients with Urinary Stress Incontinence with or without Genital Prolapse
title_full_unstemmed Ultrasound Characteristics of Patients with Urinary Stress Incontinence with or without Genital Prolapse
title_short Ultrasound Characteristics of Patients with Urinary Stress Incontinence with or without Genital Prolapse
title_sort ultrasound characteristics of patients with urinary stress incontinence with or without genital prolapse
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3490089/
https://www.ncbi.nlm.nih.gov/pubmed/23136629
http://dx.doi.org/10.4111/kju.2012.53.10.691
work_keys_str_mv AT antovskavesnas ultrasoundcharacteristicsofpatientswithurinarystressincontinencewithorwithoutgenitalprolapse