Prediction of risk factors for postpartum stress urinary incontinence based on pelvic floor ultrasound combined with clinical information.

OBJECTIVE

To identify the independent risk factors for postpartum stress urinary incontinence by combining pelvic floor ultrasound parameters with clinical information.

METHODS

Pelvic floor examination and clinical data were collected from 152 postpartum women who underwent pelvic floor ultrasound at Yancheng Third People's Hospital between December 2023 and September 2024. Independent risk factors for postpartum stress urinary incontinence were identified using multivariate logistic regression analysis. A nomogram model was constructed using R 4.3.1 software and the rms package to evaluate the correlation between the identified factors and the disease.

RESULTS

Maximal Valsalva state posterior urethrovesical angle (RVA), bladder neck descent, and Young's modulus of the resting posterior lip of the urethral sphincter were identified as independent risk factors for postpartum stress urinary incontinence (p < 0.05). The areas under the receiver operating characteristic curve for RVA, bladder neck descent, and posterior lip of the urethral sphincter were 0.840, 0.867, and 0.914, respectively, indicating high diagnostic efficiency. The nomogram model demonstrated that the risk of developing stress urinary incontinence increased with higher RVA and bladder neck descent values and lower posterior lip of the urethral sphincter values, with posterior lip of the urethral sphincter showing the strongest correlation with the disease.

CONCLUSION

RVA (Valsalva), bladder neck descent, and posterior lip of the urethral sphincter are independent risk factors for postpartum stress urinary incontinence. The nomogram model based on these factors demonstrated high diagnostic performance (area under the curve = 0.984), suggesting potential utility for clinical application. However, this model is preliminary and requires validation in larger, multicenter cohorts before widespread use.