Medical & Clinical Research

Author(s): Moein Moradpour

Background: The value of imaging modalities especially transperineal ultrasound in assessment and categorization of pelvic floor disorders in women remains ambiguous. The aim of this study was to compare the diagnostic value of transperineal ultrasound with urodynamic test in assessment of stress urinary incontinence.

Methods: This cross-sectional study was conducted on women referred to pelvic floor clinic at Mahdieh hospital with the complaint of stress urinary incontinence. Along with physical examination, urodynamic test and pelvic floor ultrasound were requested for all participants.

Results: The patients were divided into two groups with pelvic organ prolapse (n=25) and without pelvic organ prolapse (n=18). There was no difference between the two groups with and without pelvic organ prolapse in β angle greater than 120 degrees during rest and maneuvering Valsalva, and the rate of bladder neck funneling. In the groups with and without prolapsed, the sensitivity and specificity of β angle greater than 120 degrees measuring by ultrasound at rest to determine stress urinary incontinence were 80.0% and 60.0% in the group with prolapsed and 70.0% and 50.0% in those without prolapse. The pointed values for β angle greater than 120 degrees during Valsalva maneuver were 93.3% and 40.0% in those without prolapsed and 80.0% and 12.5% in those without prolapse respectively. The evaluation of bladder neck funneling by ultrasound could diagnose stress urinary incontinence with a sensitivity of 10.0% and a specificity of 62.5% in the group without pelvic organ prolapse and with a sensitivity of 53.8% and a specificity of 80.0% in those with pelvic organ prolapse respectively.

Conclusion: The use of ultrasound alone is not sufficient to diagnose stress urinary incontinence, especially in cases where there is no evidence of pelvic organ prolapse, and thus comprehensive use of physical examinations and imaging techniques for such a diagnosis is recommended.