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Published in: International Urogynecology Journal 8/2013

01-08-2013 | Original Article

Can urodynamic stress incontinence be diagnosed by ultrasound?

Authors: H. P. Dietz, K. Nazemian, K. L. Shek, A. Martin

Published in: International Urogynecology Journal | Issue 8/2013

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Abstract

Introduction and hypothesis

Multichannel urodynamic testing is commonly used to diagnose urodynamic stress incontinence (USI). It has been claimed that USI may be diagnosed by imaging. In this study we determined the predictive value of ultrasound findings for USI.

Methods

This is an observational study utilising data obtained during urodynamic testing. Data sets were analysed in 209 patients in order to determine the predictive value of sonographic findings for the diagnosis of USI.

Results

Bladder neck descent and maximal urethral pressure were the only independent predictors of USI identified by multivariate logistic regression. The finding of a cystourethrocele with funnelling increased the odds of a diagnosis of USI by 2.5 (95 % confidence interval 1.17–5.4, p = 0.018).

Conclusions

Translabial ultrasound can identify an anatomical configuration that is associated with USI. However, sonographic findings are insufficient to predict USI and can not replace urodynamic testing.
Literature
1.
go back to reference Lemack GE (2004) Urodynamic assessment of patients with stress incontinence: how effective are urethral pressure profilometry and abdominal leak point pressures at case selection and predicting outcome? Curr Opin Urol 14(6):307–311PubMedCrossRef Lemack GE (2004) Urodynamic assessment of patients with stress incontinence: how effective are urethral pressure profilometry and abdominal leak point pressures at case selection and predicting outcome? Curr Opin Urol 14(6):307–311PubMedCrossRef
2.
go back to reference Huang Y, Chen H (2007) Computer-aided diagnosis of urodynamic stress incontinence with vector-based perineal ultrasound using neural networks. Ultrasound Obstet Gynecol 30(7):1002–1006PubMedCrossRef Huang Y, Chen H (2007) Computer-aided diagnosis of urodynamic stress incontinence with vector-based perineal ultrasound using neural networks. Ultrasound Obstet Gynecol 30(7):1002–1006PubMedCrossRef
3.
go back to reference Lewicky-Gaupp C, Blaivas JG, Clark A, McGuire EJ, Schaer G, Tumbarello J, Tunn R, DeLancey J (2009) “The cough game”: are there characteristic urethrovesical movement patterns associated with stress incontinence? Int Urogynecol J Pelvic Floor Dysfunct 20(2):171–175PubMedCrossRef Lewicky-Gaupp C, Blaivas JG, Clark A, McGuire EJ, Schaer G, Tumbarello J, Tunn R, DeLancey J (2009) “The cough game”: are there characteristic urethrovesical movement patterns associated with stress incontinence? Int Urogynecol J Pelvic Floor Dysfunct 20(2):171–175PubMedCrossRef
4.
go back to reference Dietz HP (2011) Pelvic floor ultrasound in incontinence: what’s in it for the surgeon? Int Urogynecol J 22(9):1085–1097PubMedCrossRef Dietz HP (2011) Pelvic floor ultrasound in incontinence: what’s in it for the surgeon? Int Urogynecol J 22(9):1085–1097PubMedCrossRef
5.
go back to reference Dietz HP (2011) Pelvic floor ultrasound in prolapse: what’s in it for the surgeon? Int Urogynecol J 22:1221–1232PubMedCrossRef Dietz HP (2011) Pelvic floor ultrasound in prolapse: what’s in it for the surgeon? Int Urogynecol J 22:1221–1232PubMedCrossRef
6.
go back to reference Shek KL, Dietz HP (2008) The urethral motion profile: a novel method to evaluate urethral support and mobility. Aust N Z J Obstet Gynaecol 48:337–342PubMedCrossRef Shek KL, Dietz HP (2008) The urethral motion profile: a novel method to evaluate urethral support and mobility. Aust N Z J Obstet Gynaecol 48:337–342PubMedCrossRef
7.
go back to reference Green TH (1975) Urinary stress incontinence: differential diagnosis, pathophysiology, and management. Am J Obstet Gynecol 122(3):368–400PubMed Green TH (1975) Urinary stress incontinence: differential diagnosis, pathophysiology, and management. Am J Obstet Gynecol 122(3):368–400PubMed
8.
go back to reference Hall AF, Theofrastous JP, Cundiff GW, Harris RL, Hamilton LF, Swift SE, Bump RC (1996) Interobserver and intraobserver reliability of the proposed International Continence Society, Society of Gynecologic Surgeons, and American Urogynecologic Society pelvic organ prolapse classification system. Am J Obstet Gynecol 175 (6):1467–1470; discussion 1470–1471; comment in Am J Obstet Gynecol, 1997, 177:248 Hall AF, Theofrastous JP, Cundiff GW, Harris RL, Hamilton LF, Swift SE, Bump RC (1996) Interobserver and intraobserver reliability of the proposed International Continence Society, Society of Gynecologic Surgeons, and American Urogynecologic Society pelvic organ prolapse classification system. Am J Obstet Gynecol 175 (6):1467–1470; discussion 1470–1471; comment in Am J Obstet Gynecol, 1997, 177:248
9.
go back to reference Dietz HP, Shek KL (2008) Validity and reproducibility of the digital detection of levator trauma. Int Urogynecol J Pelvic Floor Dysfunct 19:1097–1101PubMedCrossRef Dietz HP, Shek KL (2008) Validity and reproducibility of the digital detection of levator trauma. Int Urogynecol J Pelvic Floor Dysfunct 19:1097–1101PubMedCrossRef
10.
go back to reference Eisenberg V, Chantarasorn V, Shek K, Dietz H (2010) Does levator ani injury affect cystocele type? Ultrasound Obstet Gynecol 36:618–623PubMedCrossRef Eisenberg V, Chantarasorn V, Shek K, Dietz H (2010) Does levator ani injury affect cystocele type? Ultrasound Obstet Gynecol 36:618–623PubMedCrossRef
11.
go back to reference Chantarasorn V, Dietz H (2012) Diagnosis of cystocele type by clinical examination and pelvic floor ultrasound. Ultrasound Obstet Gynecol 39(6):710–714PubMedCrossRef Chantarasorn V, Dietz H (2012) Diagnosis of cystocele type by clinical examination and pelvic floor ultrasound. Ultrasound Obstet Gynecol 39(6):710–714PubMedCrossRef
12.
go back to reference Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A, Standardisation Sub-committee of the International Continence Society (2002) The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21(2):167–178PubMedCrossRef Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A, Standardisation Sub-committee of the International Continence Society (2002) The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21(2):167–178PubMedCrossRef
13.
go back to reference Holtedahl K, Verelst M, Schiefloe A, Hunskaar S (2000) Usefulness of urodynamic examination in female urinary incontinence—lessons from a population-based, randomized, controlled study of conservative treatment. Scand J Urol Nephrol 34:169–174PubMedCrossRef Holtedahl K, Verelst M, Schiefloe A, Hunskaar S (2000) Usefulness of urodynamic examination in female urinary incontinence—lessons from a population-based, randomized, controlled study of conservative treatment. Scand J Urol Nephrol 34:169–174PubMedCrossRef
14.
go back to reference Lose G, Thyssen H (1996) Reproducibility of cystometry and pressure-flow parameters in female patients. Neurourol Urodyn 15:302–303 Lose G, Thyssen H (1996) Reproducibility of cystometry and pressure-flow parameters in female patients. Neurourol Urodyn 15:302–303
15.
go back to reference Weidner A, Myers ER, Evan R, Visco A, Cundiff G, Bump R (2001) Which women with stress incontinence require urodynamic evaluation? Am J Obstet Gynecol 184:20–27PubMedCrossRef Weidner A, Myers ER, Evan R, Visco A, Cundiff G, Bump R (2001) Which women with stress incontinence require urodynamic evaluation? Am J Obstet Gynecol 184:20–27PubMedCrossRef
16.
go back to reference Hodgkinson CP (1953) Relationships of the female urethra and bladder in urinary incontinence. Am J Obstet Gynecol 65:560–573 Hodgkinson CP (1953) Relationships of the female urethra and bladder in urinary incontinence. Am J Obstet Gynecol 65:560–573
17.
go back to reference Green TH Jr (1978) Static cystourethrograms in stress urinary incontinence. Am J Obstet Gynecol 132(2):228–232PubMed Green TH Jr (1978) Static cystourethrograms in stress urinary incontinence. Am J Obstet Gynecol 132(2):228–232PubMed
18.
go back to reference Drutz HP, Shapiro BJ, Mandel F (1978) Do static cystourethrograms have a role in the investigation of female incontinence? Am J Obstet Gynecol 130(5):516–520PubMed Drutz HP, Shapiro BJ, Mandel F (1978) Do static cystourethrograms have a role in the investigation of female incontinence? Am J Obstet Gynecol 130(5):516–520PubMed
19.
go back to reference Dietz H, Wilson P (2004) The ‘iris effect’: how two-dimensional and three-dimensional ultrasound can help us understand anti-incontinence procedures. Ultrasound Obstet Gynecol 23:267–271PubMedCrossRef Dietz H, Wilson P (2004) The ‘iris effect’: how two-dimensional and three-dimensional ultrasound can help us understand anti-incontinence procedures. Ultrasound Obstet Gynecol 23:267–271PubMedCrossRef
20.
go back to reference Dietz HP, Beer-Gabel M (2012) Ultrasound in the investigation of posterior compartment vaginal prolapse and obstructed defecation. Ultrasound Obstet Gynecol 40:14–27PubMedCrossRef Dietz HP, Beer-Gabel M (2012) Ultrasound in the investigation of posterior compartment vaginal prolapse and obstructed defecation. Ultrasound Obstet Gynecol 40:14–27PubMedCrossRef
21.
go back to reference Lose G (1997) Urethral pressure measurement. Acta Obstet Gynecol Scand Suppl 166:39–42 Lose G (1997) Urethral pressure measurement. Acta Obstet Gynecol Scand Suppl 166:39–42
22.
go back to reference Dietz HP, Clarke B (2001) The urethral pressure profile and ultrasound imaging of the lower urinary tract. Int Urogynecol J Pelvic Floor Dysfunct 12(1):38–41PubMedCrossRef Dietz HP, Clarke B (2001) The urethral pressure profile and ultrasound imaging of the lower urinary tract. Int Urogynecol J Pelvic Floor Dysfunct 12(1):38–41PubMedCrossRef
23.
go back to reference Pirpiris A, Shek K, Dietz H (2010) Urethral mobility and urinary incontinence. Ultrasound Obstet Gynecol 36:507–511PubMedCrossRef Pirpiris A, Shek K, Dietz H (2010) Urethral mobility and urinary incontinence. Ultrasound Obstet Gynecol 36:507–511PubMedCrossRef
24.
go back to reference Dietz H, Bond V, Shek K (2011) Does childbirth alter the reflex pelvic floor response to sudden increases in intra-abdominal pressure? Ultrasound Obstet Gynecol. doi:10.1002/uog.10083 Dietz H, Bond V, Shek K (2011) Does childbirth alter the reflex pelvic floor response to sudden increases in intra-abdominal pressure? Ultrasound Obstet Gynecol. doi:10.​1002/​uog.​10083
25.
go back to reference Dietz HP, Wilson PD (1999) The influence of bladder volume on the position and mobility of the urethrovesical junction. Int Urogynecol J Pelvic Floor Dysfunct 10(1):3–6PubMedCrossRef Dietz HP, Wilson PD (1999) The influence of bladder volume on the position and mobility of the urethrovesical junction. Int Urogynecol J Pelvic Floor Dysfunct 10(1):3–6PubMedCrossRef
Metadata
Title
Can urodynamic stress incontinence be diagnosed by ultrasound?
Authors
H. P. Dietz
K. Nazemian
K. L. Shek
A. Martin
Publication date
01-08-2013
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 8/2013
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-012-2032-4

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