3D High frequency Endovaginal Ultrasound evaluation of Ureth
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The exact cause of pregnancy-related stress urinary incontinence remains unclear. The ultrasonographic examination of the urethra became important in clinical practice. This study adds new information to the pathophysiology of stress urinary incontinence during pregnancy.

Scientists aimed to compare the morphological characteristics of the pelvis and urethra in nulliparous pregnant women with and without stress urinary incontinence (SUI) by 3D high-frequency endovaginal ultrasound (3D-EVUS).

At 36-38 weeks of gestation, 40 nulliparous pregnant women with and without SUI underwent 3D-EVUS assessment. The anteroposterior and transverse diameters of levator hiatus (LH), pubovisceral muscle thicknesses at 3,9 and 12 o’clock, right and left paravaginal areas, symphysis angle, bladder-symphysis distance (BSD), urethral complex thickness (Ut), urethral complex width (Uw), urethral complex volume (UV), urethral length (UL), intramural urethra, rhabdosphincter thickness (Rt), rhabdosphincter width (Rw), rhabdosphincter length (RL), and rhabdosphincter volume (RV) were measured by 3D-EVUS.

--Longer LH transverse diameter, shorter LH anteroposterior diameter, and wider symphysis angle were detected in nulliparous pregnant women with SUI compared to those without SUI.

--RV of less than 1.26 cm3 was found to have a sensitivity of 100% and a specificity of 100% for the presence of SUI in nulliparous pregnant women.

In conclusion, constitutionally different pelvic shapes and decreased urethral rhabdosphincter measurements can be used to predict SUI in nulliparous pregnant women.

European Journal of Obstetrics & Gynecology and Reproductive Biology
Source: https://doi.org/10.1016/j.ejogrb.2021.04.037
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