Transvaginal and Perineal Ultrasonography in Measurement of Resting Urethral Angles in A Cohort of Continent Iraqi Women

Background: Ultrasonography of the pelvic floor, either by the trans-perineal or the endo-vaginal/introital approach, has been effectively utilized in the diagnostic workup of urinary incontinence. Anterior and posterior urethral angles, funneling of bladder neck, urethral hypermobility and bladder base position can be evaluated using pelvic floor ultrasonograph.
Objective: To assess the impact of variability of ultrasound technique (transvaginal ultrasound; TVS, and transperineal; TPUS) on the measurement of the resting urethral angles in a sample of continent Iraqi women.
Methods: This study included 100 healthy continent adult females, The numerical values of the urethral angles were obtained by both TVS and TPUS techniques in a sample of women attending Ultrasound Unit in Al-Imamein Al-kadhimein Medical City during 2017.
Results: The α angle mean of studied women measured by TVS was 91.92 while that measured by TPUS was 78.67 with highly significant difference between both techniques (p<0.001). Conversely, the ẞ angle mean of studied women measured by TVS was 102.25 while that measured by TPUS was 112.08 with highly significant difference between both techniques (p<0.001). As a result, the α angle was higher among continent women by TVS and ẞ angle was higher among continent women by TPUS. Although no significant difference, the average α angle increased with increased age of continent women while average ß angel was decreased with increased age of continent women. The average α angle of continent women was significantly increased among obese multiparous women at age group <40 years age (p=0.007). The average B angle of continent women was significantly increased among obese multiparous women at age group <40 years age (p<0.001).
Conclusion: The ultrasound approach whether TVS or TPUS have an essential impact on the measured numerical value of different urethral angles, and the women age, parity and body habitus individually and in combination affect the measurement of the urethral angles.
Keywords: Transvaginal ultrasound, transperineal ultrasound, resting urethral angle, continent women
Citation: Farhan RM, Fakher TS, Hummadi NA, Al-Saadi WI. Transvaginal and perineal ultrasonography in measurement of resting urethral angles in a cohort of continent Iraqi women. Iraqi JMS. 2023; 21(2): 278-286. doi: 10.22578/IJMS.21.2.16