3D high frequency endovaginal ultrasound evaluation of urethral and pelvic morphology in stress urinary incontinence in first pregnancy

Objective: We aimed to compare the morphological characteristics of pelvis and urethra in nulliparous pregnant women with and without stress urinary incontinence (SUI) by 3D high-frequency endovaginal ultrasound (3D-EVUS). Study design: At 36-38 weeks of gestation, 40 nulliparous pregnant women with and without SUI underwent 3D-EVUS assessment. The anteroposterior and transverse diameters of levator hiatus (LH), pubovisceral muscle thicknesses at 3,9 and 12 o'clock, right and left paravaginal areas, symphysis angle, bladder-symphysis distance (BSD), uretral complex thickness (Ut), urethral complex width (Uw), urethral complex volume (UV), urethral length (UL), intramural urethra, rhabdosphincter thickness (Rt), rhabdosphincter width (Rw), rhabdosphincter length (RL), and rhabdosphincter volume (RV) were measured by 3D-EVUS. Results: Longer LH transverse diameter (34.8 +/- 3.8 mm vs 31.1 +/- 2.1 mm), shorter LH anteroposterior diameter (47.8 +/- 6.2 mm vs 52.4 +/- 2.6 mm), and wider symphysis angle (116.3 +/- 5.6 vs 111.5 +/- 5.3 degrees) were detected in nulliparous pregnant women with SUI compared those without SUI (p = 0.001, p = 0.001 and p = 0.013; respectively). RV of less than 1.26 cm(3) was found to have a sensitivity of 100 % and a specificity of 100 % for the presence of SUI in nulliparous pregnant women. Conclusions: Constitutionally different pelvic shape and decreased urethral rhabdosphincter measurements can be used to predict SUI in nulliparous pregnant women. (C) 2021 Elsevier B.V. All rights reserved.

Automated summary

The study compared the morphological characteristics of pelvis and urethra in nulliparous pregnant women with and without stress urinary incontinence (SUI) using 3D high-frequency endovaginal ultrasound (3D-EVUS). Women with SUI were found to have longer levator hiatus transverse diameter, shorter anteroposterior diameter, and wider symphysis angle compared to those without SUI. Additionally, a rhabdosphincter volume of less than 1.26 cm(3) was found to be a sensitive and specific predictor of SUI in nulliparous pregnant women.