J Korean Soc Med Ultrasound.  1998 Sep;17(3):215-219.

Transrectal Ultrasonography in Sitting Position in Stress Urinary Incontinence

• Kim SW
• Yun JK
• Lee JS
• Lee IG
• Kim BY
• Lee JG
• Kim HJ

Abstract

PURPOSE: To evaluate the usefulness of transrectal ultrasonography in sitting position in the assessment of urinary incontinence in female patients. MATERIALS & METHODS: Transrectal ultrasonography was performed to twenty two patients with stress urinary incontinence(mean age 50.7) and ten patients without urinary incontinence(mean age 42.5). Using a sagittal section of the anterior pelvis, the posterior urethro-vesical angle(PUVA), the pubo-urethral distance and the beaking of internal urethral orifice were measured at rest and during stress(Ualsalva's maneuver state). The student T-test and Fisher's exact test were used for statistial analysis.
RESULTS
Mean PUVA of the control group was 128.8 degrees(+/- 11.2 standard deviation) at rest and 145.0 degrees(+/- 9.2) during stress. In the patients, the corresponding angles were 142.0 degrees(+/- 7.8) and 164.9 degrees(+/- 7.1) respectively. The PUVA was increased 16.2 degrees(+/- 11.6) in the control group and 22.9 degrees(+/- 9.6) in the patients(p <0.05). In the controls, the pubo-urethral distance was 14.3mm(+/- 2.8) at rest and 16.5mm(+/- 1.6) during stress, while in the patients this distance was 18.1mm(+/- 5.0) and 22.7mm(+/- 5.7). The pubo-urethral distance was increased 2.2mm(+/- 2.1) in control group and 4.6mm(+/- 3.8) in the patients(p>0.05). However there was no statistically significant difference in the PUVA and the pubo-urethral distance between patients with mild incontinence(Grade I) and moderate incontinence(Grade II)(p>0.05). The beaking og internal urethral orifice was absent in any of control group, but was present in all patients(p<0.05). The diagnostic criteria of urinary stress incontinence were >151.5 degrees of PUVA during stress(sensitivity 95.5%, specificity 80%), <17.6mm of pubo-urethral distance during stress(sensitivity 86.4%, specificity 60%), and presence of the beaking of internal urethral orifice(sensitivity 100%, specificity 100%).
CONCLUSION
Transrectal ultrasonography in sitting position may be useful for assessment of urinary incontinence.

MeSH Terms

Animals
Beak
Female
Humans
Pelvis
Sensitivity and Specificity
Ultrasonography*
Urinary Incontinence*
Urinary Incontinence, Stress