This study is aimed at developing and validating a new integral parameter, the Biomechanical Integrity score (BI-score) of the female pelvic floor for stress urinary incontinence conditions.
A total of 130 subjects were included in the observational cohort study; 70 subjects had normal pelvic floor conditions, and 60 subjects had stress urinary incontinence (SUI). A Vaginal Tactile Imager (VTI) was used to acquire and automatically calculate 52 biomechanical parameters for eight VTI test procedures (probe insertion, elevation, rotation, Valsalva maneuver, voluntary muscle contractions in two planes, relaxation, and reflex contraction). Statistical methods were applied (t test, correlation) to identify the VTI parameters sensitive to the pelvic SUI conditions.
Twenty-seven parameters were identified as statistically sensitive to SUI development. They were subdivided into five groups to characterize tissue elasticity (group 1), pelvic support (group 2), pelvic muscle contraction (group 3), involuntary muscle relaxation (group 4), and pelvic muscle mobility (group 5). Every parameter was transformed to its standard deviation units using the dataset for normal pelvic conditions, similar to the T-score for bone density. Linear combinations with specified weights led to the composition of five component parameters for groups 1-5 and to the BI-score in standard deviation units. The p value for the BI-score has p = 4.0 × 10-28 for SUI versus normal conditions.
Quantitative transformations of the pelvic tissues, support structures, and functions under diseased conditions may be studied with the SUI BI-score in future research and clinical applications.
International urogynecology journal. 2024 May 13 [Epub ahead of print]
Peter Takacs, Dávid Rátonyi, Erzsébet Koroknai, Heather van Raalte, Vincent Lucente, Vladimir Egorov, Zoard Tibor Krasznai, Bence Kozma
Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Eastern Virginia Medical School, Norfolk, VA, USA., Faculty of Medicine, Department of Obstetrics and Gynecology, University of Debrecen, Nagyerdei Krt 98, 4032, Debrecen, Hungary., The Institute for Female Pelvic Medicine & Reconstructive Surgery, Allentown, PA, USA., Princeton Urogynecology, Princeton, NJ, USA., Advanced Tactile Imaging, Ewing, NJ, USA., Faculty of Medicine, Department of Obstetrics and Gynecology, University of Debrecen, Nagyerdei Krt 98, 4032, Debrecen, Hungary. .