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Assessment of female pelvic floor support to the urethra using 3D transperineal ultrasound

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Abstract

Introduction and hypothesis

To explore the feasibility of three-dimensional (3D) transperineal tomographic ultrasound in evaluating pelvic floor support of the urethra in women.

Methods

Three-dimensional transperineal ultrasound volume data sets of 50 women with stress urinary incontinence (SUI) and 25 women without SUI were obtained for analysis. Pelvic floor support of the urethra was evaluated by studying the relationship between the urethra and vagina in vaginal cross section and quantified by estimating the urethral depression (UD) rate. The extent of paravaginal support at level II was also evaluated in tomographic ultrasound imaging (TUI) mode in all participants. Two-sample t-test and Mann-Whitney U test were used for statistical analysis.

Results

The extent of paravaginal support at level II showed no difference between the two groups. Posterior depression of the urethra into the anterior vaginal wall was increased in SUI (P < 0.05). When the UD rate value was 0.53 (CI 85%) combined with three continuous “abnormal slices,” the maximum Youden Index value (sensitivity 0.82, specificity 0.88) was obtained to screen dysfunctional support of the urethra.

Conclusions

The pelvic floor support of the urethra can be evaluated indirectly by studying the relationship between the urethra and anterior vaginal wall in the vaginal cross section by TUI. The obvious posterior depression of the urethra into the anterior vaginal wall could be indirect evidence of a defect in the support of the urethra.

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Funding

This study was funded by the National Science Foundation of China (no. 81571699) and Shanghai Key Discipline of Medical Imaging (no. 2017ZZ02005).

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Author notes

  1. Wen Shui and Yijia Luo contributed equally to this work and should be listed as co-first authors.

Authors and Affiliations

  1. Department of Ultrasound in Medicine, Shanghai Institute of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai, 200233, China

    Wen Shui, Yijia Luo, Tao Ying, Chaoran Dou & Minzhi Zhou

  2. Medical Imaging Department, Shanghai Jiahui International Hospital, 689 Guiping Road, Shanghai, 200233, China

    Qin Li

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  1. Wen Shui
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  2. Yijia Luo
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  3. Tao Ying
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  5. Chaoran Dou
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  6. Minzhi Zhou
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Correspondence to Tao Ying or Qin Li.

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Shui, W., Luo, Y., Ying, T. et al. Assessment of female pelvic floor support to the urethra using 3D transperineal ultrasound. Int Urogynecol J 31, 149–154 (2020). https://doi.org/10.1007/s00192-019-03946-5

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  • DOI: https://doi.org/10.1007/s00192-019-03946-5

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