| Objective: With the increase of age,stress urinary incontinence(SUI)rates are also rising.It seriously affects women’s physical and mental health,quality of life and social style,and also brings heavy burden to family and society.The occurrence of SUI is closely related to the abnormal pelvic floor anatomical structure,so it is increasingly important to comprehensively and effectively evaluate the changes in the female pelvic floor anatomical structure and function of SUI.Ultrasound technology has the advantages of economy,non-invasive,non-radiation,real-time,and dynamic.What’s more,with a good soft tissue resolution,ultrasound can build similar to the pelvic floor anatomical structure of the sagittal plane,coronal plane and cross-sectional images,and has good repeatability.Therefore,in this study,we used transperineal ultrasound to analyze the relationship between the changes of pelvic floor motor function and SUI in primipara after delivery.So,we would understand the morphology and movement of pelvic floor tissues such as bladder and urethra,so as to analyze their relationship with the occurrence and development of postpartum SUI.Methods: We randomly selected 226 cases of primipara at 6-8 weeks after delivery,who visited the Female Pelvic Floor Urinary Reconstructive Center in Dalian Municipal Women and Children’s Medical Center from 2014 to 2018.According to the symptoms of urine leakage in the postpartum patients with increased abdominal pressure,they were divided into 104 patients in the postpartum SUI group,namely the study group,and 122 patients in the postpartum SUI free group,namely the control group.By transperineal ultrasound,we used ultrasonic data to analyze two groups from the pelvic floor exercise level.The data included genital tract hiatus anteroposterior diameter,the distance from the bladder neck to the pubis,the distance from the bladder neck to the pubis,bladder neck descent,bladder bottom descent,urethral length,urethral inclination,urethral movement angle,area of retropubic space,perineal area,perineal body movement distance,posterior bladder angle,anorectal angulation,and distance of protrusion of rectum at rest and Valsalva condition.The data covered the anterior and posterior pelvic cavity in order to explore more objective indicators of the occurrence of SUI.Results: Comparison of general data showed that the age of the study group was larger than that of the control group(29.47±2.29 vs 28.52±2.43,P=0.006),and the second stage of labor of the study group was longer than that of the control group(0.99±0.52 vs 0.87±0.49,P=0.017).Age was used as covariate and covariance was used to analyze the results of transperineal ultrasound.At rest and Valsalva condition,the genital tract hiatus anteroposterior diameter in the study group was larger than that in the control group,and the difference was more obvious at Valsalva condition(rest: 49.74±7.08 vs 47.11±9.02,P=0.026;Valsalva: 58.02±9.49 vs 53.40±9.45,P=0.002).Bladder neck descent,bladder bottom descent and urethral movement angle in the study group were larger than that in the control group(18.24±7.60 vs 12.75±9.93,P=0;19.37±9.48 vs 13.19±10.82,P=0;-48.16±30.46 vs-36.89±31.85,P=0.010).The urethral length in the study group was shorter than that in the control group(rest: 28.74±3.53 vs 30.35±3.90,P=0.002;Valsalva: 24.35±3.34 vs 26.78±4.80,P=0.0).The perineal area in the study group was less than that in the control group(rest: 97.95±38.53 vs 127.48±46.94,P=0.0;Valsalva: 119.38±57.90 vs 149.79±62.17,P=0.0).At Valsalva condition,the posterior bladder angle in the study group was larger than that in the control group(172.73±26.97 vs 161.75±25.27,P=0.003).Conclusion: Current research results suggest that transperineal ultrasound can be used to detect the pelvic floor anatomical characteristics of postpartum SUI patients.In the future,transperineal ultrasound can be used to detect the postpartum female pelvic floor anatomical structure changes and biomechanical changes before clinical symptoms,so as to provide an objective basis for early treatment. |
