Association of urinary and anal incontinence with measures of pelvic floor muscle contractility

S. H. Oversand, Ixora Kamisan @ Atan, K. L. Shek, H. P. Dietz

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: To assess the association between clinical and sonographic measures of pelvic floor muscle (PFM) function and symptoms of urinary and anal incontinence (AI). Methods: This was a retrospective study of women seen at a tertiary urogynecological unit. All women had undergone a standardized interview, clinical examination including Modified Oxford Scale (MOS) grading, urodynamic testing and four-dimensional translabial ultrasound (TLUS). Cranioventral shift of the bladder neck (BN) and reduction in the hiatal anteroposterior (AP) diameter were measured using ultrasound volumes acquired on maximal PFM contraction, blinded against all clinical data. Results: Data from 726 women with a mean age of 56±13.7 (range, 18-88) years and a mean body mass index of 29±6.1 (range, 17-55) kg/m2 were analyzed. Stress (SI) and urge (UI) urinary incontinence were reported by 73% and 72%, respectively, and 13% had AI. Mean MOS grade was 2.4±1.1(range, 0-5). Mean cranioventral BN shift on TLUS was 7.1±4.4(range, 0.3-25.3)mm; mean reduction in AP hiatal diameter was 8.6±4.8 (range, 0.3-31.3)mm. On univariate analysis, neither MOS nor TLUS measures were strongly associated with symptoms of urinary incontinence or AI; associations were non-significant except for BN displacement/SI (7.3mm vs 6.5mm; P=0.028), BN displacement/UI (6.85 vs 7.75; P=0.019), hiatal AP diameter/AI (9.6mm vs 8.5mm; P=0.047) and MOS/SI (2.42 vs 2.19; P=0.013). Conclusions: In this large retrospective study we did not find any strong associations between sonographic or palpatory measures of PFM function and symptoms of urinary incontinence or AI.

Original languageEnglish
JournalUltrasound in Obstetrics and Gynecology
DOIs
Publication statusAccepted/In press - 2016

Fingerprint

Pelvic Floor
Urinary Incontinence
Urinary Bladder
Muscles
Retrospective Studies
Urge Urinary Incontinence
Urodynamics
Muscle Contraction
Body Mass Index
Interviews

Keywords

  • 3D/4D ultrasound
  • Anal incontinence
  • Pelvic floor
  • Translabial ultrasound
  • Urinary incontinence

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Reproductive Medicine

Cite this

Association of urinary and anal incontinence with measures of pelvic floor muscle contractility. / Oversand, S. H.; Kamisan @ Atan, Ixora; Shek, K. L.; Dietz, H. P.

In: Ultrasound in Obstetrics and Gynecology, 2016.

Research output: Contribution to journalArticle

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N2 - Objective: To assess the association between clinical and sonographic measures of pelvic floor muscle (PFM) function and symptoms of urinary and anal incontinence (AI). Methods: This was a retrospective study of women seen at a tertiary urogynecological unit. All women had undergone a standardized interview, clinical examination including Modified Oxford Scale (MOS) grading, urodynamic testing and four-dimensional translabial ultrasound (TLUS). Cranioventral shift of the bladder neck (BN) and reduction in the hiatal anteroposterior (AP) diameter were measured using ultrasound volumes acquired on maximal PFM contraction, blinded against all clinical data. Results: Data from 726 women with a mean age of 56±13.7 (range, 18-88) years and a mean body mass index of 29±6.1 (range, 17-55) kg/m2 were analyzed. Stress (SI) and urge (UI) urinary incontinence were reported by 73% and 72%, respectively, and 13% had AI. Mean MOS grade was 2.4±1.1(range, 0-5). Mean cranioventral BN shift on TLUS was 7.1±4.4(range, 0.3-25.3)mm; mean reduction in AP hiatal diameter was 8.6±4.8 (range, 0.3-31.3)mm. On univariate analysis, neither MOS nor TLUS measures were strongly associated with symptoms of urinary incontinence or AI; associations were non-significant except for BN displacement/SI (7.3mm vs 6.5mm; P=0.028), BN displacement/UI (6.85 vs 7.75; P=0.019), hiatal AP diameter/AI (9.6mm vs 8.5mm; P=0.047) and MOS/SI (2.42 vs 2.19; P=0.013). Conclusions: In this large retrospective study we did not find any strong associations between sonographic or palpatory measures of PFM function and symptoms of urinary incontinence or AI.

AB - Objective: To assess the association between clinical and sonographic measures of pelvic floor muscle (PFM) function and symptoms of urinary and anal incontinence (AI). Methods: This was a retrospective study of women seen at a tertiary urogynecological unit. All women had undergone a standardized interview, clinical examination including Modified Oxford Scale (MOS) grading, urodynamic testing and four-dimensional translabial ultrasound (TLUS). Cranioventral shift of the bladder neck (BN) and reduction in the hiatal anteroposterior (AP) diameter were measured using ultrasound volumes acquired on maximal PFM contraction, blinded against all clinical data. Results: Data from 726 women with a mean age of 56±13.7 (range, 18-88) years and a mean body mass index of 29±6.1 (range, 17-55) kg/m2 were analyzed. Stress (SI) and urge (UI) urinary incontinence were reported by 73% and 72%, respectively, and 13% had AI. Mean MOS grade was 2.4±1.1(range, 0-5). Mean cranioventral BN shift on TLUS was 7.1±4.4(range, 0.3-25.3)mm; mean reduction in AP hiatal diameter was 8.6±4.8 (range, 0.3-31.3)mm. On univariate analysis, neither MOS nor TLUS measures were strongly associated with symptoms of urinary incontinence or AI; associations were non-significant except for BN displacement/SI (7.3mm vs 6.5mm; P=0.028), BN displacement/UI (6.85 vs 7.75; P=0.019), hiatal AP diameter/AI (9.6mm vs 8.5mm; P=0.047) and MOS/SI (2.42 vs 2.19; P=0.013). Conclusions: In this large retrospective study we did not find any strong associations between sonographic or palpatory measures of PFM function and symptoms of urinary incontinence or AI.

KW - 3D/4D ultrasound

KW - Anal incontinence

KW - Pelvic floor

KW - Translabial ultrasound

KW - Urinary incontinence

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