Diagnostic Value of a Multiparametric Model Based on Pelvic Floor Ultrasound for Postpartum Stress Urinary Incontinence.

BACKGROUND

To explore the diagnostic value of a multiparametric model based on pelvic floor ultrasound for postpartum stress urinary incontinence (SUI).

METHODS

Between November 2023 and December 2024, 102 postpartum SUI patients (SUI group) and 96 healthy controls (control group) were enrolled. After 1:1 propensity score matching (caliper width = 0.02), 60 cases per group were analysed. Pelvic floor ultrasound was used to measure posterior urethrovesical angle at rest (Ar)/angle during Valsalva (As), urethral rotation angle (URA), bladder neck mobility (BNM), and bladder neck funnel formation. A multiparametric model was constructed using logistic regression and evaluated using receiver operating characteristic (ROC) curves.

RESULTS

The SUI group exhibited significantly higher URA, BNM, and bladder neck funnel formation rates than the control group (all p < 0.05). These three parameters were identified as independent SUI predictors with no multicollinearity (variance inflation factor (VIF) < 5). The multiparametric model achieved an area under the ROC curve of 0.863 (95% confidence interval (CI): 0.798-0.927), significantly higher than any single parameter (p < 0.05), with a sensitivity of 78.50% and a specificity of 89.80% at the optimal cut-off value.

CONCLUSIONS

The multiparametric pelvic floor ultrasound model, which integrated URA, BNM, and bladder neck funnel formation, demonstrated good diagnostic performance for postpartum SUI. This non-invasive tool, complemented by a constructed nomogram, provides a methodological basis for early identification of postpartum SUI in clinical practice, pending further multicentre validation.