OBJECTIVE: To assess the association between clinical and sonographic measures of pelvic floor muscle (PFM) function and symptoms of urinary and anal incontinence (AI).
METHODS: A retrospective study of women seen at a tertiary urogynecological unit. All women had undergone a standardized interview, clinical examination including modified Oxford Scale grading (MOS), urodynamic testing and 4D translabial ultrasound (TLUS). Cranioventral shift of the bladder neck (BN) and reduction of the hiatal anteroposterior (AP) diameter were measured using US volumes acquired on maximal PFM contraction, blinded against all clinical data.
RESULTS: Data from 726 women with a mean age of 56 (SD 13.7; range 18-88) years and a mean BMI of 29 (SD 6.11; range 17-55) kg/m2 were analyzed. Stress (SI) and urge (UI) urinary incontinence were reported by 73% and 72% respectively. Thirteen percent had anal incontinence (AI). Mean MOS was 2.4 (SD 1.1, range 0-5). Mean cranioventral BN shift on imaging was 7.1 (SD 4.36; range 0.3-25.3) mm; mean reduction of AP hiatal diameter was 8.6 (SD 4.8; range 0.3-31.3) mm. On univariate analysis neither MOS nor US measures were strongly associated with symptoms of urinary or anal incontinence (P values were all non-significant except for BN/SI (7.32 vs. 6.51 mm; P = 0.03), AP/AI (9.55 vs. 8.49 mm; P = 0.047) and MOS/SI (2.42 vs. 2.19; P = 0.013)).
CONCLUSIONS: In this large retrospective study we did not find any strong associations between sonographic or palpatory measures of pelvic floor muscle function and symptoms of urinary or anal incontinence.
Written by:
Oversand S, Kamisan Atan I, Shek KL, Dietz HP. Are you the author?
Oslo University Hospital - Ullevål, Oslo, Norway; Sydney Medical School Nepean, University of Sydney, Penrith, Australia; University of Kebangsaan, Malaysia Medical Centre, Kuala Lumpur, Malaysia; University of Western Sydney, Liverpool Clinical School, Australia.
Reference: Ultrasound Obstet Gynecol. 2015 May 19. Epub ahead of print.
doi: 10.1002/uog.14902
PubMed Abstract
PMID: 25989530