POSTPARTUM INTROITAL SONOGRAPHY OF THE LO WER URINARY-TRACT

Methods: Introital sonography was performed on 131 patients between th e first and 13th day (average 4.2 days) after delivery. 41 non-pregnan t nulliparous women without any complaints of urinary incontinence ser ved as controls. Post-partum morphological changes were analysed using a 5-MHz vaginal scanner and correlated with parity and mode of delive ry. Results: The occurrence of cystoceles and opening of the proximal urethra were strongly related with parity and mode of delivery being m ore common in multiparous women after vaginal deliveries than after ca esarean sections. In the control group, the urethrovesical angle beta was 96 degrees in rest and 102 degrees when straining. After vaginal d eliveries, a significantly larger angle was observed when compared to patients after caesarean section. During straining, the bladder neck s hortened from 21.4 mm to 13.1 mm compared to -0.7 mm after vaginal del ivery. Conclusion: Morphological changes of the lower urinary tract af ter delivery are common. The sonographic appearance of these changes i s almost identical to those observed in patients with urinary stress i ncontinence.