Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Radio-diagnosis

Objective: Stress urinary incontinence (SUI), defined as involuntary loss of urine during increased abdominal pressure, due to intrinsic sphincter deficiency or to hypermobility of the bladder neck or urethra is the most commonly encountered type of female urinary incontinence. Our study aimed at assessing and comparing the role of ultrasound (US) and magnetic resonance imaging (MRI) in those patients. methods: Twenty patients (mean age: 44.05 years old) with an established clinical diagnosis of SUI as well as 5 female volunteers (mean age: 43 years old) underwent pelvic floor (perineal) 2D-US and MRI (static & dynamic). The US evaluation included measurement of the bladder wall thickness, detrusor muscle thickness, urethral length and thickness as well as assessment of the retrovesical angle at rest and with strain. At MRI, descent of the bladder below the pubococcygeal line, H & M lines measurements, levator plate orientation, vaginal configuration, puborectalis muscle and levator hiatus width were assessed. results: MRI study showed that inpatients, there was statistically significant (p<0.05) elongation of H line at rest and with pelvic strain (mean: 6.43 versus 4.71cm in controls at rest and 7.69 versus 5.20cm with strain respectively), widening of the elevator hiatus (4.17 cm versus 3.20cm in controls) as well as puborectalis abnormalities (in 55% of patients). On trans-vaginal US, there was statistically significant increased detrusor muscle thickness with SUI (mean: 0.16 versus 0.12cm in controls), shortened urethral length (2.74 versus3.17cm in controls) and increased retrovesical angle with strain (140 versus 121{u00B0} in controls)

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