The influence of posture on perineal ultrasound imaging parameters

A prospective clinical study was carried out to evaluate the influence of p osture on perineal ultrasound imaging parameters. One hundred and thirty-tw o consecutive women presenting with symptoms of lower urinary tract dysfunc tion were examined by multichannel videourodynamics and perineal ultrasound , both supine and standing. Ultrasound included color Doppler imaging when available, i.e. in a subgroup of 99 patients. The position of the bladder n eck at rest was higher in the supine position (P <0.001) and it descended f urther on Vaisalva (P <0.001), to reach an almost identical final position. There was a higher degree of urethral rotation on supine imaging (P = 0.00 1). Urethral funneling on Valsalva was more likely in the erect position (P <0.001), as was urine leakage documented by color Doppler imaging (P<0.001) . The effect of a pelvic floor contraction was not significantly influenced by posture. Imaging of the urethrovesical junction should be undertaken in both supine and erect positions to document optimally both hypermobility a nd funneling or leakage.