Real-time Two-dimensional Ultrasound In Women With Stress Urinary Incontinence Clinical Value Of Research

[Objective] This paper is to explore the clinical diagnostic value of real-time two-dimensional ultrasound in women with stress urinary incontinence(SUI):to observe the anatomic structure of SUI patients with anterior pelvic,and in order to obtain the diagnosis standard of two-dimensional ultrasound in patients with SUI and the standard of clinical grading.(Methods] In this study,there are143women including SUI patients and normal women. The test subjects were divided into four groups,respectively,the normal group of54patiens which has not given birth, the normal group of42patiens which has given birth, SUI-Ⅰ degrees group of22patients which has given birth, SUI-Ⅱ degrees group of25patients which has given birth.Nulliparous normal group needs to meet following criteria:no history of childbirth,and by the clinical routine gynecological examination and pressure testing inspection except pelvic organ prolapse; control group satisfies the following conditions:birthe history(all of natural childbirth), and by the clinical routine gynecological examination and pressure testing inspection except pelvic organ prolapse; the group of SUI-Ⅰ needs to meet following criteria:by clinical and urodynamic diagnosis of SUI-Ⅰ severe patients, and by the clinical routine gynecological examination and pressure testing inspection except pelvic organ prolapse,-the group of SUI-Ⅱ needs to meet following criteria:by clinical and urodynamic diagnosis of SUI-Ⅱ severe patients, and by the clinical routine gynecological examination and pressure testing inspection except pelvic organ prolapse; Inspection equipment are the PHILIP IU-22and HD11-XE color doppler ultrasonography, convex array probe, frequency of3.0MHz-5.0MHz.Check the condition selection machine preset abdominal pelvic examination conditions, depth adjustment is8.0cm-9.0cm, rasied to observe the target central focus.The patient in the supine lithotomy position, the probe outsourcing isolation units and placed urethral perineum between the orificium urethrae externum and the vagina.Appropriate pressure but does not cause the patient’s obvious discomfort.In the sagittal section clearly shows the lower edge of the pubic symphysis, bladder, urethra, vagina, and try to make the public symphysis angle with the horizontal axis at45degree or so.Reference level is the line through lower edge of the public symphysis, observed and recorded both the resting state and the maximum Valsalva state bladder neck and urethra form, sonography, and dynamic changes, including the bladder neck,(BN),. BN’s activity, retrovesical angle (RA) and urethral tilt angle(UTA), after a satisfactory image freeze the image and save it. All images are used PmsDView system for image post-measurement analysis. All data are input using Excel to create databases.Using SPSS17.0statistical software for data processing and analysis.Descripted normal distribution data as mean±standard(x±s), non-normal distribution data as median±quartile(M±Q).Using analysis of variance, rank sum test and chi-square analyzed the result of each group.Groups compared using Least significance difference(LSD). P<0.05was considered statistically significance.[Results]1.In pelvic sagittal plane, two-dimensinal ultrasound image from ventral todorsal order to show the pubic symphysis, bladder neck and urethra, vagina, rectum.2. Nulliparous normal group, control group observed indicators comparison:Nulliparous normal group and the control group BN activity, RArest, UTAval no significant difference between the two groups; nulliparous normal group RAval lower than the control group, nulliparous normal group UTArest higher han the control group, RAval, UTArest comparison between groups were statistically significant(P<0.05).3. SUI-Ⅰ group, SUI-Ⅱ group and control group observed indicatorscomparison:(1)BN:BN compared among the SUI-1group, SUI-Ⅱ group and the control group showed that the three groups differ BN dilatation; Further comparison by Bonfferoni adjustment pairwise shows:SUI-Ⅰ group and SUI-Ⅱ group BN dilatation were higher than control group, and the difference was statistically significant(P<0.05). But SUI-Ⅰ group and SUI-Ⅱ group BN dilatation no difference, indicating BN dilatation for the diagnosis of SUI has clinical significance, while for the clinical significance is no indexing.(2) Activity of BN、RA and UTA comparison:Activity of BN:Activity of BN among the three groups comparison, in descending order are SUI-Ⅱ>SUI-Ⅰ>control group, and the difference was statistically significant (P<0.05). Activity of BNof SUI-Ⅰ group is (1.72±0.54)cm> Activity of BN of SUI-Ⅱ group is (2.60±0.95)cm。RA, UTA:Three groups RA and UTA comparison showed, RAval, UTAval measured values were different among the three groups; Further pairwise comparisons showed that:SUI-Ⅰ group and SUI-Ⅱ group RAval, UTAval all higher than the control group, and the difference was statistically significant(P<0.05). But SUI-Ⅰ group and SUI-Ⅱ group comparison between groups, RAval and UTAval no difference; RArest, UTArest between the three groups were not statistically different.[Conclusions]1. Perineal real-time two-dimensional ultrasound imaging techniques can be used to observe female SUI patients prior pelvic anatomy of the pelvic floor.2. Perineal real-time two-dimensional ultrasound imaging technology can be used diagnostic SUI, its diagnostic indicators are:Valsalva state bladder neck was expanding, activity of BN, RAval,UTAval.3. Activity of BN can be used for SUI-Ⅰ degrees, SUI-Ⅱ degree indexing initial diagnos...