Iraqi Journal of Medical Sciences

Vol. 10 Issue 4 October - December / 2012
Published on website | Date : 2016-04-03 18:21:31


Liqaa R Al-Khuzaee, Wassan IM Al-Saadi


Background:Urinary incontinence is a silent epidemic severly affecting the quality of life of women. Urodynamic study is the gold standard investigation for assessing women with urinary incontinence. However it is invasive and unavailable in some hospitals. Ultrasound is safe, noninvasive and available in most units.
Objective:To determine the role of perineal ultrasound for assessing the bladder neck mobility, pubo urethral angle and retrovesical angle during rest and straining in normal women and in those with stress urinary incontinence.
Methods:Twenty patients with urodynamic stress urinary incontinence and twenty age-matched control patients were included in the study. Perineal sonography was carried out in both groups to evaluate the role of this technique in the diagnosis of stress urinary incontinence. By using the posterior edge of the symphysis pubis as a reference point, posterior urethra-vesical angle (PUVA) and the angle between the vertical axis and urethral axis (alpha angle) were measured at rest and on straining. Bladder neck mobility was evaluated only at the cephalocaudal plane by measuring the desensus diameter.
Results:Posterior urethro-vesical angle (PUVA) was found to be significantly different between the study and control groups both at rest and on straining (P < 0.05). The pubo urethral angle (alpha angle) was found to be significantly different between study and control groups only on straining (P < 0.05).Cephalocaudal distance (desensus diameter) of urethra was longer in patients with stress urinary incontinence (P < 0.05).
Conclusion:Perineal sonography has an important role in diagnosing patients with stress urinary incontinence.
Key words: Perineal ultrasound, stress urinary incontinence, bladder neck