Application Of Two-Dimensional Perineal Ultrasound In Female Patients With Stress Urinary Incontinence

Objective:This study aims to study the ultrasonic imaging characteristics of female pelvic organs and pelvic floor structures by examine anterior compartment structures of female pelvic organ with two-dimensional perineal ultrasonography.The movement of the pelvic organs during valsalva stress was observed.Quantified,measured and analyzed ultrasonic parameters to explore the auxiliary diagnostic value of transperineal ultrasonography for SUI.Methods:1.Select 40 female patients presented stress leakage as complaint at the gynecology outpatient in the Affiliated Hospital of Tai shan Medical College during December,2015 to December,2016.All the patients were maternal,and confirmed as stress urinary incontinence.The 40 female patients were selected as the experimental group.According to the Cullen indexing,clinical manifestations of SUI is divided into four degrees:I degree: stress leakage occurs occasionally when increase abdominal pressured;II degree:urinary incontinence occurs when increase abdominal pressure;III degree:stress leakage occurs when standing;IV degree:urinary incontinence occurs when Standing or reclining.The patients of I degree and II degree were divided into SUI1 group.the patients of III and IV degree were divided into SUI2 groups.40 SUI patients(SUI group)were divided into SUI 1 group(n=30)and SUI 2 group(n=10).Control group had 30 patients,were also maternal and without Stress Urinary Incontinence.The 70 patients were examined by twodimensional transperineal ultrasonography at resting and valsalva state.Different states of midsagittal view of the pelvic floor were obtained.Ultrasound imaging shows the shape of symphysis pubis,the bladder,urethra,vagina and anal canal clearly.2.ultrasonic parameters Measured bladder neck-symphyseal vertical distance at resting state(R-BNS)and at maximum Valsalva state(V-BNS).According to the the above data calculate the Bladder neck down distance(BND= R-BNS-V-BNS);funnel shape internal urethral orifice.Results:1.BND in control group were lower than SUI group.There was statistic difference in BND between SUI group and control group(P<0.05).2.BND in SUI 1 group were lower than SUI 2 group.There was statistic difference in BND between SUI 1group and SUI 2 group(P<0.05).3.The rate of funnel shape internal urethral orifice in SUI1 group was lower than SUI2 group.But there was no statistic difference in funnel shape internal urethral orifice between SUI1 group and SUI2 group(P>0.05).Conclusion:1.The occurrence of SUI is associated with hypermobility of bladder neck.BND can be used as an indicator in SUI diagnosis.2.The degree of bladder neck mobility can reflect the severity of SUI indirectly.3.The appearance of unnel shape internal urethral orifice reflect the Lack of pelvic floor supporting structure.But the rate of funnel shape internal urethral orifice wasn't increases with the severity of SUI.