Clinical radiology · 2025
Incorporation of transperineal ultrasonography and pelvic electromyography into the real clinical setting for the prediction of postpartum stress urinary incontinence.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Feng Q, Wang K, Huang J M, Xu W T, Yang H H, He Y
Аннотация
AIM: Risk factors for predicting postpartum stress urinary incontinence (SUI) attract increasingly more attention. Here, we incorporate transperineal ultrasonography (US) and pelvic floor electromyography into the real clinical setting, aiming to evaluate various risk factors comprehensively and objectively and weigh their roles in predicting postpartum SUI.
MATERIALS AND METHODS: A total of 530 subjects were enrolled. SUI was diagnosed using the International Consultation on Incontinence Questionnaire-Short Form. The clinical, ultrasonographic, and myoelectric data of the subjects were collected. Risk factors of postpartum SUI were analysed in this integrated context. The performance of different combined risk factors models was tested and internally verified.
RESULTS: The maternal age, body mass index, hypertension, parity, the bladder neck-symphysis distance during the Valsalva manoeuvre, retrovesical angle during the Valsalva manoeuvre and abnormal fatigue degree of type Ⅱ muscle fibres were independent risk factors of postpartum SUI (P<0.05). Assisted vaginal birth was more associated with SUI than cesarean birth in primipara subgroups by modes of delivery (P=0.040). The combined model of clinical, ultrasonographic, and myoelectric factors showed optimal performance in predicting SUI (C-statistics = 0.771). The efficacy of the combination of clinical and ultrasonographic variables was slightly lower (C-statistics = 0.762, P=0.167). The calibration curves of both models above were well-fitted.
CONCLUSION: Compared with simple clinical factors, the combination of clinical and sonographic factors significantly increased the odds of predicting postpartum SUI with similar efficacy as the optimal combination of clinical, ultrasonographic, and myoelectric three aspects, which suggested the necessary role of transperineal US examination in SUI.
MATERIALS AND METHODS: A total of 530 subjects were enrolled. SUI was diagnosed using the International Consultation on Incontinence Questionnaire-Short Form. The clinical, ultrasonographic, and myoelectric data of the subjects were collected. Risk factors of postpartum SUI were analysed in this integrated context. The performance of different combined risk factors models was tested and internally verified.
RESULTS: The maternal age, body mass index, hypertension, parity, the bladder neck-symphysis distance during the Valsalva manoeuvre, retrovesical angle during the Valsalva manoeuvre and abnormal fatigue degree of type Ⅱ muscle fibres were independent risk factors of postpartum SUI (P<0.05). Assisted vaginal birth was more associated with SUI than cesarean birth in primipara subgroups by modes of delivery (P=0.040). The combined model of clinical, ultrasonographic, and myoelectric factors showed optimal performance in predicting SUI (C-statistics = 0.771). The efficacy of the combination of clinical and ultrasonographic variables was slightly lower (C-statistics = 0.762, P=0.167). The calibration curves of both models above were well-fitted.
CONCLUSION: Compared with simple clinical factors, the combination of clinical and sonographic factors significantly increased the odds of predicting postpartum SUI with similar efficacy as the optimal combination of clinical, ultrasonographic, and myoelectric three aspects, which suggested the necessary role of transperineal US examination in SUI.