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  • Title: [The effect of bladder filling on changes in ultrasonography parameters of the lower urinary tract in women with urinary stress incontinence].
    Author: Martan A, Masata J, Halaska M, Otcenásek M, Lochman P.
    Journal: Ceska Gynekol; 2000 Jan; 65(1):10-3. PubMed ID: 10750290.
    Abstract:
    OBJECTIVE OF THE STUDY: Was to evaluate the effect of filling the bladder on position and mobility of UV junction, and to determine other possible changes of measured ultrasound parameters of the lower urinary tract in relation to filling of the bladder. TYPE OF STUDY: Prospective randomized clinical study. NAME AND ADDRESS OF THE WORKPLACE: Department of Gynaecology--Obstetrics, 1st Faculty of Medicine of Charles University and VFN in Prague. METHODOLOGY: 20 women were included in our study with proved stress incontinence of urine ("GSI"). Their average age was 46 years, average weight 70 kg, average parity 1.57. Perineal and introital ultrasound examination was performed in a supine position, using Acuson 128 XP 10 equipment, a convex probe of 5 MHz frequency and a vaginal probe of 7.0 MHz. Position and mobility of UVJ was monitored based on the following parameters: angle gamma, abscissas p, h, x, y. Bladder filling was 300 ml, 200 ml and empty bladder. RESULTS: Statistically significant differences were observed in UVJ mobility during contractions of pelvic floor muscles between measurements, when the bladder contained 300 ml of liquid, or was empty (p = 0.00983). UV-junction of and empty bladder is higher during a contraction, and the mobility is greater (p = 0.006). Distances x, y, p in case of an empty bladder are shorter during contraction and the gamma angle is smaller (p = 0.01). The thickness of the bladder wall was greater in an empty bladder (p = 0.01). Changes in area and thickness of the urethral sphincter were not significant. CONCLUSIONS: Based on our preliminary results we can state that a bladder filling of 300 ml is not significant for evaluation of UV-junction mobility. Rather the opposite; a higher mobility of UV-junction was observed with an empty bladder. Monitoring of the inner orifice of the urethra with an empty bladder presents a slight problem. To evaluate vesicalisation of the proximal urethra and to confirm insufficiency of the inner sphincter (ISD), a filling in the bladder is necessary. The thickness of the bladder wall is measured with an empty bladder.
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