Clinical Application Study Of Pelvic Floor Ultrasound Combine Muscles Electrophysiological Electrophysiological Examination In Female Stress Urinary Incontinence

Objective To detective the clinical application value in diagnosis of female stress urinary incontinence (FSUI) with pelvic floor ultrasound and pelvic floor muscles electrophysiological examination. Multiple factors logistic regression analysis were performed to evaluate the correlation of risk of pelvic floor ultrasound combine pelvic floor muscles electrophysiological examination parameters with FSUI.Methods Transperineal pelvic floor two dimensional ultrasound were performed in 77 women with FSUI (case group) and 41 healthy women without FSUI (control group). The bladder urethra angle(a) and the bladder neck with or whitout funnel in resting state, dynamic changes of the bladder neck y axis displacement (Ay) and x axis displacement (Δx) and the proximal urethra rotation angle (γ) from resting state to valsalva’s maneuer, the bladder urethra angle (β) after valsalva’s maneuer, and the cystocele and descensus uteri was obverved. At the same time,The pelvic floor muscles electrophysiological examination were performed with the french PHENIX USB8 neuromuscular stimulation therapy apparatus,to evaluated the type I pelvic floor muscle fibers’ strength, the type Ⅰ pelvic floor muscle fibers’fatigue, the type Ⅱ pelvic floor muscle fibers’ strength, the type Ⅱ pelvic floor muscle fibers’fatigue(According to the French national health diagnostic criteria,the strength examination was divided into level 0-Ⅴ,smaller than level Ⅲ was abnormal.the fatigue test refers to the largest contraction of muscle strength to 6 s decline in the percentage ratio,0% was normal,negative was abnormal). Then the two groups’ parameters were compared. Multiple factors logistic regression analysis were performed to evaluate the correlation of risk of pelvic floor ultrasound combine pelvic floor muscles electrophysiological examination parameters(Δy,Ax,α,β,γ,the bladder neck with funnel,the type Ⅰ pelvic floor muscle fibers’ strength,the type Ⅰ pelvic floor muscle fibers’ fatigue,the type Ⅱ pelvic floor muscle fibers’ strength,the type Ⅱ pelvic floor muscle fibers’ fatigue) with FSUI.Result (1) α,Funnel formation of the bladder neck in resting state, Δy,β and γ of case group were greater than those of the control group (all P<0.05). (2) The cystocele rate and descensus uteri rate of case group were greater than those of the control group (all P<0.05).(3) Δx of case group was greater than that of the control group, but there was no significant statistical difference (P>0.05).(4) The type Ⅰ pelvic floor muscle fibers’ strength,the type Ⅰ pelvic floor muscle fibers’fatigue,the type Ⅱ pelvic floor muscle fibers’ strength,the type Ⅱ pelvic floor muscle fibers’ fatigue of case group were be 69%(53/77),100%(77/77),22%(17/77),84%(65/77)respectively,The control groups’ were be 51%(21/41),40/41(97%),22%(9/41),78%(32/41) respectively,The abnormality rate of twe groups were higher, but there was no significant statistical difference (all P>0.05).(5) Through the multi-factor logistic regression analysis, Δy,funnel formation of the bladder neck,type Ⅰ pelvic floor muscle fibers’strength had significant correlation with FSUI (P<0.05). From the OR point estimates,The woman have bigger Ay,funnel formation of the bladder neck,smaller type Ⅰ pelvic floor muscle fibers’strength will suffer from FSUI. From the standardized regression coefficients, The woman have bigger Ay will suffer from FSUI with greatest risk,then is funnel formation of the bladder neck.smaller type Ⅰ pelvic floor muscle fibers’strength.Conclusion Pelvic floor ultrasound can display pelvic floor tissue real time and dynamically, providing experienced imaging informations for FSUL Pelvic floor muscles electrophysiological examination can early and effectively evaluate the female pelvic floor muscle function, and to guide the clinical intervention in time, prevent or postpone the development of FSUI symptoms. Combine the twe examinations,we could get the comprehensive assessment of the pelvic floor of FSUI patients. It has important significance in prediction, diagnosis, treatment choice, clinical classification and prognostic evaluation of FSUI.