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| The ultrasonographic observation of bladder neck in patients with different degrees of #br#
stress urinary incontinence and analysis of best diagnostic threshold |
| MA Lin, KAN Yan-min, LI Ning, ZHANG Ying, LI Jian, LIU Shui-peng |
| Department of Ultrasound, the North China University of Science and Technology Affiliated Hospital, Tangshan Hebei 063000, China |
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Abstract Objective: To observe and analyze the bladder neck in patients with different degrees of stress urinary incontinence(SUI) through transperineal ultrasound, and to find the best diagnostic threshold of SUI. Methods: A total of 255 cases of SUI(111 cases of mild SUI group, 96 moderate SUI group, 48 severe SUI group) were selected from September 2014 to February 2016 in our hospital, 266 cases in the same period for healthy patients as normal control group, and the transperineal ultrasonography was performed on the selected subjects, recorded the bladder neck back shift(ΔDx), the downward distance(ΔDy), the bladder neck movement(Mu) and the bladder neck rotation angle(θ) after the forced breathing maneuver. The ultrasound data were analyzed and compared. According to the results of multivariate Logistic regression analysis, the ROC curve of θ were constructed, and the diagnostic threshold of SUI was preliminarily determined. Results: The comparison among four groups, the values of Mu, θ in the normal control group, mild SUI group, moderate SUI group, severe SUI group increased in turn, ΔDy of SUI patients were higher than those of the normal control group, ΔDy of moderate SUI group and severe SUI group were higher than those of the mild SUI group, ΔDx of moderate and severe SUI group were higher than those of normal and mild SUI group, the differences were statistically significant(P<0.05). Multivariate Logistic regression analysis showed that age, high BMI, ΔDy, Mu, and θ were all in the regression equation, and the regression coefficient of θ was the highest. When θ was 21.5°, the sensitivity and specificity of the diagnosis of SUI were higher. Conclusion: With the increase of the degree of SUI, the migration of the female bladder neck in the pelvic cavity increases significantly, the age and high BMI are all the risk factors for the occurrence of SUI, ΔDy, Mu, θ can be used as the ultrasonic diagnostic indexes of SUI, and θ can be used as the best diagnostic index, and the θ value of 21.5° can be used as the best diagnostic threshold.
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Received: 01 December 2017
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