Use of transvaginal endosonography in the evaluation of women with stress urinary incontinence.

Hypermobility of the bladder neck in response to increased intra-abdominal pressure is the anatomical cause of uncomplicated stress urinary incontinence in women. Transvaginal endosonography is a reliable, minimally invasive technique for demonstrating bladder neck hypermobility in patients with genuine stress urinary incontinence. Of 279 patients with genuine stress urinary incontinence evaluated during a 24-month period 271 (97%) had bladder neck hypermobility demonstrated by transvaginal endosonography. Resolution of stress urinary incontinence after surgical bladder neck suspension correlated with stabilization of bladder neck mobility on ultrasound examination. The technique is painless and easily performed in the office setting.