Article Sidebar
Views PDF: 94
CLINICAL, URETHRAL DYNAMIC MAGNETIC RESONANCE CHARACTERISTICS OF FEMALE PATIENTS WITH STRESS URINARY INCONTINENCE
Main Article Content
Abstract
Purpose: To describe the clinical and uro-dynamic magnetic resonance characteristics of a group of female patients with stress urinary incontinence (SUI). Material and methods: 22 female patients with SUI were underwent a urethral MRI using static and dynamic pulse sequences. Static MRI pulses were used to assess the length, volume of the urethra, the thickness of the striated-smooth muscle layer as well as the supporting ligaments around the urethra. Urethral dynamic MRI pulses (at rest and voiding) were used to evaluate urethral angle, posterior vesicoureteral angle, bladder neck- pubococcygeal angle, as well as the position of bladder neck and cervix relative to the pubococcygeal line (PCL). The pulse sequence measurements are compared between resting and voiding to assess the amplitude of movement of urethral structures in stress condition. Results: The mean age of the group of patients was 53.9±12.6 mm, the oldest was 74 years old, the youngest was 13 years old. The average number of births was 2.1 ±0.7, the maximum number of births was 3 times. Vaginal delivery accounted for 16/22 patients (73%). The duration of SUI from 1-5 years accounted for 63.7%, > 5 years accounted for 23.7%. Severe SUI disorder accounted for 68%. On static pulse sequences, the mean length and mean urethral volume were 30.8 ± 6.2 mm and 5.5 ± 2.1 cm3, respectively, and the thickness of the striated and smooth muscle layers of the urethra were 2.2±0.53 mm and 5.1±0.47 mm, respectively, defects in periurethral support structures account for 40%. On dynamic pulse sequences, mean urethral angle, posterior bladder-urethral angle, bladder-neck angle at rest and voiding phase were 18.1±10.40 and 53.8±37.40, respectively; 145.3±130 and 171.2±13.50; 52.6±18.30 and 45.7±26.40. The positions of bladder neck and cervix relative to the PCL at rest and voiding were: (-) 15.6±7.5 mm and (+) 5.4±12.7 mm; (-) 31.1±14.7 mm and (-) 10.5±17.1 mm. Conclusion: Our study showed the clinical features, anatomical structures of urethra and urethral-bladder neck complex in female patients with SUI disorder. These parameters would be compared to the group of patients without SUI disorder to find the cause of SUI.
Article Details
Keywords
Dynamic pelvic floor MRI, Stress urinary incontinence, Posterior urethro vesical angle.
References
2. Nygaard IE, Heit M. Stress Urinary Incontinence: Obstet Gynecol. 2004;104(3):607-620.
3. Kobra Falah-Hassani, Joanna Reeves et al. The pathophysiology of stress urinary incontinence: a systematic review and meta-analysis. International Urogynecology Journal (2021) 32:501–552
4. Li N, Cui C, Cheng Y, Wu Y, Yin J, Shen W. Association between Magnetic Resonance Imaging Findings of the Pelvic Floor and de novo Stress Urinary Incontinence after Vaginal Delivery. Korean J Radiol. 2018;19(4):715.
5. DuBeau CE. The Aging Lower Urinary Tract. J Urol. 2006;175(3S).
6. Tasali N, Cubuk R, sinanoğlu O, Şahin K, Saydam B. MRI in Stress Urinary Incontinence Endovaginal MRI With an Intracavitary Coil and Dynamic Pelvic MRI. Urol J. 2012;9:397-404.
7. Zidan S, Amin M, Hemat E, Samaha I. Female urinary incontinence: spectrum of findings at pelvic mri and urodynamics. Zagazig Univ Med J. 2016;22:1-9.
8. Tarhan S, Gümüş B, Temeltaş G, Ovali GY, Serter S, Göktan C. The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery. Turk J Med Sci. Published online January 1, 2010.
9. Ansquer Y, Fernandez P et al. MRI urethrovesical junction mobility is associated with global pelvic floor laxity in female stress incontinence. Acta Obstet Gynecol Scand. 2007;86(10):1243-1250.
10. Lee KS, Sung HH, Na S, Choo MS. Prevalence of urinary incontinence in Korean women: results of a National Health Interview Survey. World J Urol. 2008;26(2):179-185.