The role of three-dimensional ultrasonography in estimation of posterior vesico-urethral angle in women with urinary incontinence
Article published in Urologia Polska 2003/56/1.

authors

Norbert Stachowicz, Jarosław Daniłoś, Artur Czekierdowski, Wiesława Bednarek, Jan Kotarski: I Katedra i Klinika Ginekologii Akademii Medycznej w Lublinie
Kierownik kliniki: prof, dr hab. Jan Kotarski

keywords

urinary tract, urinary incontinence, three-dimensional ultrasonography

summary

The aim of the study. Urinary incontinence is frequent in peri- and posl-menopausa women. The aim of this study is to estimate a role of three-dimensional ultrasonography in examination of posterior vesico-urethral angle in women suffering urinary incontinence.

Materiał. The results of three-dimensional ultrasonography obtained in 24 women with stress urinary incontinence, as well as in 20 women with urge incontinence, were analysed. Patient were examined in rest and Valsalva lest conditions.

Results. The difference in the mean values of the posterior vesico-urethral angle in patients with stress ;ind urge incontinence was statistically significant (p<0.05). The increase of Ihese values was significantly higher in patients with stress incontinence than in those with urge incontinence (p = 0,001).

Conclusions. Our results show that ultrasonographic three-dimensional estima-tion of posterior vesico-urethral angle is a useful preliminary diagnostic method in urinary incontinence. Posterior vesico-urethral eingle value may be important in diagnosing the relative importance of stress or ihe neurogenic component in incontinence. Thus, it makes it possible to apply a specific, surgical or phannacological, treatment.

references

1. Jurkovic D: Three-dimensional ultrasound in gynecology: a critical evaluation. Ultrasound Obstet Gynecol 2002:19:109-117.
2. Sudol-Szopińska I, Cendrowski K. Jakubowski W. Sawicki W Stelmachów J: Możliwości trójwymiarowej a idosonografii w ocenie dolnych dróg moczowych u kobiet z xo.etn.ym.amem moczu. Gin Prakt 2002; 2:11-16.
3. Hmek VVH, Obermair A, Stutlerecker D, Haiisler G. Leodoltcr S, Hanzal E: Three-dimensional idtrasoundofihefemale urethra: comparing transvaginal and transrectal scanning. Ultrasound Obstet Gynecol 2001:17:425-430.
4. Feichtinger W: Transvaginal three-dimensional imagimg. Ultrasound Obstet Gynecol 1993; 3: 375-378.
5. Frauschcr P. Helweg G, StrasserH. Enna 13, Hauser A. Knapp K, Col-leselli K, Barlsch G. Zur Nadden D: Tntnmretliral ultrasound: diagnostic evaluation of the striated urethral sphincter in incontinent females. Eur Radiol 1998;8:50-53.
6. Pregazzi R, Sartore A, Bortoli P, Troiano L, Guaschino S: Ultrasonographic assessment ofwelhrovesictd mobility in women. Archivio Italia-no di Urologia. Andrologia 2000; 72: 335-339.
7. Petri E, Kolbl H. Sohaer G: What is the place of ultrasound in urogyne-cology? A written panel. Inl Urogynecol J 1999; 10: 262-2 73.
8. Stachowicz N. Bednarek W. Czekierdowski A. Kotarski J: Ultrasound examination of the urinary tract after hysterectomy. Materiały zjazdowe- Kongres International Continence Society (ICS) 30th Annual Meeting 28-31.8.2000 \'[\'ampere, Finland.
9. Korion II, Kisiel A. Oszukowski P: Retrospektywna ocena efektów leczenia operacyjnego drogą brzuszną i pochwowa wysiłkowego nielrzymania moczu. Gin Prakt 2001: 7: 89-91.
10. Tbozs-Hobson P, Khullar V, Cardozo I.: Three-dimensional idtrasound: a novel technique for investigating the urethral sphincter in the third tri-i nester of pregnancy. Ultrasound Obstet Gynecol 2001:17:421-424.
11. Zalewski J, Wojciechowski A, Floriański J: Zastosowanie ultrasonografii przeiprze.dsionkowej w diagnostyce nielrzymania moczu u kobiet. Gin Prakt 1999; 8: 49-51.
12. Riccabona M. Nelson TR. Prclorius DII. Davison TE. In vivo three-dimensional sonographic measurements of organ volume: validation in the urinary bladder. | Ultrasound Med 1996:15: 627.

correspondence