Effectiveness of ultrasonographic parameters for documenting the severity of anatomic stress incontinence

Background. To assess the correlation between the severity of incontinence and some ultrasonographic parameters used to document the mobility of bladd er neck. Methods. The severity of the incontinence and mobility the bladder neck wer e evaluated by pad test and perineal ultrasonography respectively in 74 pat ients with pure anatomic stress incontinence. During perineal ultrasonograp hy, distances from the bladder neck to the lower tip (A) and to the posteri or midpoint of symphysis pubis (B) were measured at rest and during stress. The first bladder neck mobility was obtained by two caliper method (Mu). A fter superimposing the symphysis pubis of the frozen images, the bladder ne ck positions at rest and during stress were plotted on an x-y coordinate sy stem by using computer programs and the corresponding X and Y values were c alculated. The second bladder neck mobility was measured on this x-y coordi nate system (Mc). Paired t-test and correlation analysis were used for stat istical analysis of the data. Results. The mean Me was significantly higher than the mean Mu (p<0.01). Co mpared to the values at rest, the mean distance A did not change significan tly; however, the mean distance B increased, and X and Y values decreased s ignificantly during stress (p<0.01). The amount of urine leaked per hour ha d significant positive correlation with distance B-stress and Mc and signif icant negative correlation with Y-rest, X-stress and Y-stress (p<0.05-0.001 ). Conclusion. These data suggested that the bladder neck mobility was underes timated when it was measured by two caliper method and the absolute positio ns or mobility of the bladder neck measured by computer on an x-y coordinat e system could effectively document the severity of the decreased support o f bladder neck.