INTRAURETHRAL ULTRASOUND IN WOMEN WITH STRESS-INCONTINENCE

Objective To investigate whether the sphincter area in women can be se en and quantified with intra-urethral ultrasound (IUUS). Currently, sp hincter capacity in women is determined by clinical tests, vaginal pal pation, urodynamics and urethral pressure profile. Patients and method s A pilot study using IUUS was carried out in 32 stress incontinent an d 12 healthy women to enable the urethra and para-urethral tissue to b e visualized. Round-tipped miniature transducer-containing (20 MHz) ca theters (6 and 9 F) were tested. Both provided 15 frames per second. R eal-time 360 degrees cross-sectional ultrasound images were obtained b y using a standard intraluminal ultrasound system. The external urethr al sphincter was visualized and its circumference and area were measur ed. Results IUUS provided high resolution imaging of the urethra and s urrounding tissues. The whole length of the urethra was visualized. Th e external sphincter was easily recognized as an oval-shaped, hypoecho ic structure. Examination of 44 stress incontinent and healthy women r evealed a negative correlation between the external urethral sphincter (area and circumference) and the grade of stress incontinence (P < 0. 01). In no patient with normal urinary continence was the sphincter re duced in size (< 2.8 cm circumference). Conclusion IUUS is a useful te chnique in the diagnosis of incontinence, as conventional methods prov ide little information on the sphincter itself. The evaluation of sphi ncter size and morphology could help in the choice of therapy.