Comparison of urethral parameters in females presenting cystoceles with and without stress urinary incontinence based on dynamic magnetic resonance imaging: are they different?

Autor: Tang L; Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.; Department of Obstetrics and Gynecology, NanFang Hospital, Southern Medical University, North of Guangzhou Avenue, No. 1838, Guangzhou, 510515, Guangdong, China., Liang S; Department of Obstetrics and Gynecology, NanFang Hospital, Southern Medical University, North of Guangzhou Avenue, No. 1838, Guangzhou, 510515, Guangdong, China., Chen C; Department of Obstetrics and Gynecology, NanFang Hospital, Southern Medical University, North of Guangzhou Avenue, No. 1838, Guangzhou, 510515, Guangdong, China., Feng J; Department of Radiology, NanFang Hospital, Southern Medical University, Guangzhou, China., Chen L; Department of Obstetrics and Gynecology, NanFang Hospital, Southern Medical University, North of Guangzhou Avenue, No. 1838, Guangzhou, 510515, Guangdong, China., Peng C; Department of Obstetrics and Gynecology, NanFang Hospital, Southern Medical University, North of Guangzhou Avenue, No. 1838, Guangzhou, 510515, Guangdong, China., Liu P; Department of Obstetrics and Gynecology, NanFang Hospital, Southern Medical University, North of Guangzhou Avenue, No. 1838, Guangzhou, 510515, Guangdong, China. lpivy@126.com.
Jazyk: angličtina
Zdroj: Abdominal radiology (New York) [Abdom Radiol (NY)] 2024 Aug; Vol. 49 (8), pp. 2902-2912. Date of Electronic Publication: 2024 Mar 18.
DOI: 10.1007/s00261-023-04175-7
Abstrakt: Purpose: To compare urethral parameters between cystocele patients with and without stress urinary incontinence (SUI) and explore factors influencing SUI in cystocele patients via dynamic MRI.
Methods: The two-dimensional parameters evaluated included the paravaginal defects, levator ani muscle defects, urethral length, urethral funnel shape, bladder neck funnel width, bladder neck funnel depth, urethral angle, posterior vesicourethral angle, and anterior bladder protrusion. The three-dimensional parameters included the proximal urethra rotation angle, the distal urethra rotation angle, bladder neck mobility, urethral midpoint mobility, and external urethral meatus mobility. The independent samples t test was used for continuous variables, and the chi-square test was used for categorical variables. Binary logistic regression was used to identify factors independently associated with SUI in cystocele patients.
Results: The baseline parameters were similar between the 2 groups. Cystocele patients with SUI had a significantly higher point Aa (1.63 ± 1.06 cm vs. 0.81 ± 1.51 cm, p = 0.008); more anterior bladder protrusion (33.3% vs. 11.4%, p = 0.017); greater bladder neck mobility (36.38 ± 11.46 mm vs. 28.81 ± 11.72 mm, p = 0.005); mid-urethral mobility (22.94 ± 6.50 mm vs. 19.23 ± 6.65 mm, p = 0.014); and external urethral meatus mobility (22.42 ± 8.16 mm vs. 18.03 ± 8.51 mm, p = 0.022) than did cystocele patients without SUI. The other urethral parameters were similar in the groups (p > 0.05). Binary logistic regression showed that bladder neck mobility was independently associated with SUI in females with cystoceles (odds ratio, 1.06; 95% CI 1.015-1.107; p = 0.009).
Conclusion: Cystocele patients with SUI have a higher point Aa, more anterior bladder protrusion, and greater urethral mobility than those without SUI. Bladder neck mobility is independently associated with SUI in females with cystoceles.
Registration Number: NCT03146195.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz: