ULTRASONIC EVALUATION OF BLADDER NECK POSITION AND MOBILITY - THE INFLUENCE OF URETHRAL CATHETER, BLADDER VOLUME, AND BODY POSITION

The influence of urethral catheter, bladder volume, and body position on the ultrasonic assessment of bladder neck position and mobility was evaluated in 24 incontinent women. The bladder neck position was desc ribed by two independent parameters: BS-distance, from the bladder nec k to the lower tip of the symphysis pubis, and the rotation angle betw een the BS-line and the symphyseal middline. Catheterisation resulted in apposition of the bladder neck towards the symphysis pubis, seen as a significant shortening of the BS-distance in postmenopausal women w ithout estrogen replacement. The rotation angle was unaffected. Increa sing the bladder volume to symptomatically full resulted in increased capacity to withhold, since the rotation angle decreased 6.6-degrees. Examination in the sitting position, compared to the supine resulted i n bladder neck descent to a ''lower level,'' and the rotation angle in creased in average 16-degrees. Bladder neck mobility was unaffected by catheterisation and body position.Vaginal ultrasonic evaluation of bl adder neck suspension is recommended to be performed without a cathete r, with a comfortably full bladder in a convenient, but standardised e xamination position. (C) 1994 Wiley-Liss, Inc.