The Perineal Sonography In Diagnosis And Analysis Of 30 Cases Of Stress Urinary Incontinence

Objective:This article analyzed the clinical datas of thirty cases of stress urinary incontinence, explored the clinical significance of diagnosis and assessment in stress urinary incontinence disease with the perineal ultrasound-assisted application.Methods: The clinical datas of thirty patients of stress urinary incontinence and thirty matched control mormal women were collected, including the medical history, gynecological examination, perineal ultrasound measurement of relevant variables and the ultrasound image morphology.To act the case-control study and analyze the results.To produce the initial discussion in diagnosis of stress urinary incontinence with the perineal ultrasound-assisted.All these patients were collected in the Obstetrics and gynecology clinic for treatment in the first affiliated hospital of Dalian Medical University from Aug 2010 to Apr 2011.Results:1.The poster urethrovesical angle and the bladder angle in stress phase is larger than them in resting phase(p<0.01)both in the control group and SUI group.The degree of their diversification of the poster urethrovesical angle and the bladder anglein in SUI group is significantly increased compared with the control group(p<0.05).Urethral angle is smaller in stress phase than it is in resting phase both in the control group and the SUI group(p<0.01).The decrease of the urethral angle is much obvious in SUI group than the control group(p<0.05).The mibility of urethrovesical junction of SUI group is significantly increased compared with the control group(p<0.01).The urethral length was significantly shorter in SUI group,compared in the two groups.(p<0.01).2.The bladder angle in in stress phaseγ2> 100°as a diagnostic threshold for stress urinary incontinence,the sensitivity is 93.3%, specificity is 100%.Diagnostic threshold Δγ>15.5°,the sensitivity is 86.7%, specificity is 80%.The bladder angle in rest phaseγ1> 93°as a diagnostic threshold for stress urinary incontinence,the sensitivity is 80%, specificity is 96.7%.Diagnostic threshold for UVJ-M>1.22cmthe sensitivity is 93.3%, specificity is 66.7%. The poster urethrovesical angle in stress phaseα2>120°,the sensitivity is 80%, specificity is 83.3%.One of the most effective indicators is the bladder angle in in stress phaseγ2.Two indicatorsγ2> 100°andγ1> 93°in the diagnosis of SUI was 96.7% sensitivity and specificity of 96.7%.Diagnostic sensitivity and specificity are higher than single variable as an diagnostic indicators.The two variablesγ2 andγ1 can be combined as the diagnosis threshold of SUI.3.The poster urethrovesical angle in stress phase is larger in SUI patients observed by perineal ultrasound, funnel-like changes in severe cases.With the depth and width of the funnel shows a increasing trend in pace with the SUI level increased(P<0.05).Conclusion:1. The bladder angle in stress phase,the diversification of the bladder angle,the bladder angle in rest phase,the mibility of urethrovesical junction,the poster urethrovesical angle in stress phase could be used as as a variable to diagnostic stress urinary incontinence with the perineal ultrasound.Measurement of relevant variables with perineal ultrasound do an important role in diagnosing patients with stress urinary incontinence diease.2. Sonographic measurement of the variable width of the proximal urethra can be judged to provide an effective basis for classification the stress urinary incontinence, Whether genuine stress urinary incontinence.