Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC · 2026
Association between Bladder Descent Angle and Urinary Incontinence Subtypes During the Perinatal Period: A Prospective Longitudinal Study.
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Minami Ryoko, Ryuno Hirochika, Kawauchi Akihiro, Tateoka Yumiko
Аннотация
OBJECTIVES: This study examined the longitudinal association between bladder descent angle (BDA), measured by transperineal ultrasound (TPUS), and urinary incontinence (UI) subtypes during the perinatal period, focusing on stress urinary incontinence (SUI).
METHODS: Women with singleton pregnancies at ≥36 weeks were recruited between June 2022 and June 2025. Of 100 participants, 87 completed follow-up and were analyzed. UI was assessed using the International Consultation on Incontinence Questionnaire-Short Form, and participants were classified into groups with and without UI (UI and non-UI groups). BDA was measured using TPUS and compared between groups. Receiver operating characteristic analysis and multivariate logistic regression were performed.
RESULTS: UI prevalence was 67.0% in late pregnancy and 23.0% postpartum, with SUI as the most common subtype. BDA was higher in the participants with UI than in those without (the non-UI group) in late pregnancy (107.7° vs. 103.8°, P = 0.034) and postpartum (112.8° vs. 105.3°, P = 0.021). BDA showed a trend toward association with SUI, being higher in participants with SUI in late pregnancy (P = 0.044), although significance was not maintained after correction for multiple comparisons. Similar trends were observed postpartum. The predictive ability of late pregnancy BDA for postpartum UI was limited (area under the curve 0.552).
CONCLUSIONS: BDA measured by TPUS was associated with perinatal UI and showed a subtype-specific tendency toward SUI-related symptoms. However, its predictive value for postpartum UI and SUI was limited. BDA may reflect structural vulnerability of the pelvic floor rather than serving as an independent predictive marker.
METHODS: Women with singleton pregnancies at ≥36 weeks were recruited between June 2022 and June 2025. Of 100 participants, 87 completed follow-up and were analyzed. UI was assessed using the International Consultation on Incontinence Questionnaire-Short Form, and participants were classified into groups with and without UI (UI and non-UI groups). BDA was measured using TPUS and compared between groups. Receiver operating characteristic analysis and multivariate logistic regression were performed.
RESULTS: UI prevalence was 67.0% in late pregnancy and 23.0% postpartum, with SUI as the most common subtype. BDA was higher in the participants with UI than in those without (the non-UI group) in late pregnancy (107.7° vs. 103.8°, P = 0.034) and postpartum (112.8° vs. 105.3°, P = 0.021). BDA showed a trend toward association with SUI, being higher in participants with SUI in late pregnancy (P = 0.044), although significance was not maintained after correction for multiple comparisons. Similar trends were observed postpartum. The predictive ability of late pregnancy BDA for postpartum UI was limited (area under the curve 0.552).
CONCLUSIONS: BDA measured by TPUS was associated with perinatal UI and showed a subtype-specific tendency toward SUI-related symptoms. However, its predictive value for postpartum UI and SUI was limited. BDA may reflect structural vulnerability of the pelvic floor rather than serving as an independent predictive marker.