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Translabial Ultrasonography in the Assessment of Urethral Diameter and Intrinsic Urethral Sphincter Deficiency

Department of Obstetrics and Gynecology, Hospital de Clínicas de Porto Alegre, Medical School of Federal University of Rio Grande do Sul, Porto Alegre, Brazil.

Address correspondence to Fernando R. Oliveira, MD, PhD, Rua Dr Florêncio Ygartua 300/301, 90430-010 Porto Alegre-RS, Brazil. E-mail: oliveirafr{at}terra.com.br

Objective. The purpose of this study was to determine the role of translabial ultrasonography in the investigation of intrinsic urethral sphincter deficiency (ISD), assessing bladder neck hypermobility and urethral diameter in continent and incontinent patients. Methods. A case-control study evaluated 94 women with the diagnosis of urinary incontinence and 96 continent women. Both groups underwent translabial ultrasonography to assess bladder neck hypermobility by means of the x-y coordinate system and urethral diameter. The study was performed at Hospital de Clínicas de Porto Alegre. Results. Women with urinary stress incontinence showed significantly greater bladder neck descent than continent women and women with urge and mixed incontinence (P = .05). Women with ISD showed significantly larger urethral diameters than control subjects and incontinent women without ISD (P = .05). Of women with urinary incontinence, 78.7% had descent of greater than 10 mm, and 91.7% of the women with ISD had urethral diameters of greater than 6 mm. A urethral diameter of greater than 6 mm showed sensitivity of 91.7% and specificity of 75.6% for ISD. Conclusions. Translabial ultra-sonography has an important role in the assessment of women with urinary stress incontinence and intrinsic urethral sphincter deficiency.

Key Words: female urinary incontinence • intrinsic urethral sphincter deficiency • translabial ultrasonography • urethral diameter

Abbreviations: ANOVA, analysis of variance • ICC, intraclass correlation coefficient • ISD, intrinsic urethral sphincter deficiency • MUI, mixed urinary incontinence • ROC, receiver operating characteristic • TLU, translabial ultrasonography • UI, urge incontinence • USI, urinary stress incontinence