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Tang L, Liang S, Chen C, Feng J, Chen L, Peng C, Liu P. Comparison of urethral parameters in females presenting cystoceles with and without stress urinary incontinence based on dynamic magnetic resonance imaging: are they different? Abdom Radiol (NY) 2024; 49:2902-2912. [PMID: 38498153 DOI: 10.1007/s00261-023-04175-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 12/19/2023] [Accepted: 12/27/2023] [Indexed: 03/20/2024]
Abstract
PURPOSE To compare urethral parameters between cystocele patients with and without stress urinary incontinence (SUI) and explore factors influencing SUI in cystocele patients via dynamic MRI. METHODS The two-dimensional parameters evaluated included the paravaginal defects, levator ani muscle defects, urethral length, urethral funnel shape, bladder neck funnel width, bladder neck funnel depth, urethral angle, posterior vesicourethral angle, and anterior bladder protrusion. The three-dimensional parameters included the proximal urethra rotation angle, the distal urethra rotation angle, bladder neck mobility, urethral midpoint mobility, and external urethral meatus mobility. The independent samples t test was used for continuous variables, and the chi-square test was used for categorical variables. Binary logistic regression was used to identify factors independently associated with SUI in cystocele patients. RESULTS The baseline parameters were similar between the 2 groups. Cystocele patients with SUI had a significantly higher point Aa (1.63 ± 1.06 cm vs. 0.81 ± 1.51 cm, p = 0.008); more anterior bladder protrusion (33.3% vs. 11.4%, p = 0.017); greater bladder neck mobility (36.38 ± 11.46 mm vs. 28.81 ± 11.72 mm, p = 0.005); mid-urethral mobility (22.94 ± 6.50 mm vs. 19.23 ± 6.65 mm, p = 0.014); and external urethral meatus mobility (22.42 ± 8.16 mm vs. 18.03 ± 8.51 mm, p = 0.022) than did cystocele patients without SUI. The other urethral parameters were similar in the groups (p > 0.05). Binary logistic regression showed that bladder neck mobility was independently associated with SUI in females with cystoceles (odds ratio, 1.06; 95% CI 1.015-1.107; p = 0.009). CONCLUSION Cystocele patients with SUI have a higher point Aa, more anterior bladder protrusion, and greater urethral mobility than those without SUI. Bladder neck mobility is independently associated with SUI in females with cystoceles. REGISTRATION NUMBER NCT03146195.
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Affiliation(s)
- Lian Tang
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Obstetrics and Gynecology, NanFang Hospital, Southern Medical University, North of Guangzhou Avenue, No. 1838, Guangzhou, 510515, Guangdong, China
| | - Shiqi Liang
- Department of Obstetrics and Gynecology, NanFang Hospital, Southern Medical University, North of Guangzhou Avenue, No. 1838, Guangzhou, 510515, Guangdong, China
| | - Chunlin Chen
- Department of Obstetrics and Gynecology, NanFang Hospital, Southern Medical University, North of Guangzhou Avenue, No. 1838, Guangzhou, 510515, Guangdong, China
| | - Jie Feng
- Department of Radiology, NanFang Hospital, Southern Medical University, Guangzhou, China
| | - Lan Chen
- Department of Obstetrics and Gynecology, NanFang Hospital, Southern Medical University, North of Guangzhou Avenue, No. 1838, Guangzhou, 510515, Guangdong, China
| | - Cheng Peng
- Department of Obstetrics and Gynecology, NanFang Hospital, Southern Medical University, North of Guangzhou Avenue, No. 1838, Guangzhou, 510515, Guangdong, China
| | - Ping Liu
- Department of Obstetrics and Gynecology, NanFang Hospital, Southern Medical University, North of Guangzhou Avenue, No. 1838, Guangzhou, 510515, Guangdong, China.
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