Diagnostic value of three-dimensional pelvic floor ultrasonography and Glazer pelvic floor surface electromyography in postpartum stress urinary incontinence(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2024年第8期
- Page:
- 987-991
- Research Field:
- 医学影像物理
- Publishing date:
Info
- Title:
- Diagnostic value of three-dimensional pelvic floor ultrasonography and Glazer pelvic floor surface electromyography in postpartum stress urinary incontinence
- Author(s):
- WANG Xuelian; DING Hua
- Department of Ultrasound, the First Peoples Hospital of Wuhu, Wuhu 241000, China
- Keywords:
- Keywords: pelvic floor three-dimensional ultrasonography muscle electrophysiology postpartum stress urinary incontinence diagnostic model
- PACS:
- R445.1
- DOI:
- DOI:10.3969/j.issn.1005-202X.2024.08.010
- Abstract:
- Abstract: Objective To evaluate the value of three-dimensional pelvic floor ultrasonography and Glazer pelvic floor surface electromyography (EMG) in diagnosing postpartum stress urinary incontinence (SUI). Methods A total of 272 women who gave birth in the First Peoples Hospital of Wuhu from August 2021 to December 2022 and were re-examined within 6-8 weeks after delivery were selected as the study subjects, and divided into observation group (n=139) and control group (n=133) according to whether SUI was occurred. Both ultrasonic parameters (length of proximal urethra posterior bladder angle and size of hiatus in the levator ani muscle at rest bladder neck descent, distance of bladder neck from reference line, posterior bladder angle, and size of hiatus in the levator ani muscle on maximum Valsalve maneuver) and Glazer pelvic floor surface EMG parameters (pre-resting stage, rapid contraction stage, tension contraction stage, endurance contraction stage, post-resting stage) were compared between two groups. Receiver operating characteristic (ROC) curves were established to analyze the efficacy of each index in diagnosing postpartum SUI. Results There were no significant differences between two groups in the length of proximal urethra and the sizes of hiatus in the levator ani muscle at rest and on maximum Valsalve maneuver (P>0.05). Compared with control group, observation group had smaller posterior bladder angle at rest, while larger bladder neck descent, distance of bladder neck from the reference line, and posterior bladder angle on maximum Valsalve maneuver (P<0.05). The differences between two groups in surface EMG parameters at pre-resting stage, rapid contraction stage, tension contraction stage, endurance contraction stage and post-resting stage were trivial (P>0.05). The combined diagnostic model based on 4 parameters of three-dimensional pelvic floor ultrasonography was -0.069×bladder posterior angle at rest+0.038×bladder neck descent+0.045×distance of bladder neck from the reference line +0.097×posterior bladder angle on maximum Valsalve maneuver -10.521. ROC curve analysis revealed that for diagnosing postpartum SUI, the bladder posterior angle at rest bladder neck descent, distance of bladder neck from the reference line, posterior bladder angle on maximum Valsalve maneuver and the combined model had AUC of 0.588, 0.671, 0.775, 0.643 and 0.710, sensitivity of 52.6%, 84.2%, 73.4%, 47.5% and 59.0%, and specificity of 65.5%, 44.4%, 50.4%, 82.0% and 82.0%, respectively. Conclusion Three-dimensional pelvic floor ultrasonic parameters (posterior bladder angle at rest, and bladder neck descent, distance of bladder neck from reference line, posterior bladder angle on maximum Valsalve maneuver) have certain efficacy in diagnosing postpartum SUI, and the combined diagnosis exhibits higher efficacy.
Last Update: 2024-08-31