Usefulness of a Novel 3D-Endovaginal Ultrasound in the Assessment of Urethral Morphology and Bladder Neck in Continent and Incontinent Females

  • Dr Aleksandra Stankiewicz, Radiology Department, Children's Hospital of Medical University of Lublin, Poland
  • Dr Magdalena Wozniak, Radiology Department, Children's Hospital of Medical University of Lublin, Poland
  • Prof Andrzej Wieczorek, Radiology Department, Children's Hospital of Medical University of Lublin, Poland
  • Dr Michal Bogusiewicz, Second Department of Gynecology, Medical University of Lublin, Poland
  • Prof Tomasz Rechberger, Second Department of Gynecology, Medical University of Lublin, Poland

    • PURPOSE:
    Morphological changes of the urethra and morphology of the bladder neck could appear important in early diagnostics of incontinence. The aim of the study was to check the usefulness of novel 3D endovaginal ultrasound (EVUS) in the imaging of bladder neck and urethral morphology in continent and incontinent women.
    METHODS AND MATERIALS:
    Sixty two females mean age 45 years (range: 19-71) underwent 3D-EVUS. Twenty of them (32%) were continent, whilst 42 (68%) suffered from stress urinary incontinence (SUI). The EVUS examinations were performed using an ultrasound system (Profocus, B-K Medical) with a 9-12MHz, rotational transducer with a built-in 3D automated acquisition system and perpendicular beam formation. The 3D acquisition was performed in B-mode and with Colour Doppler mode, starting from bladder and ending beyond the external orifice of the urethra. The evaluation of the urethral complex was also performed post examination using stored data.
    RESULTS:
    In all patients a novel 3D EVUS enabled precise visualization of the urethral morphology. Bladder neck was clearly seen in all patients, so that it was possible to perform the measurements of its thickness. Typical 3-layer wall of the urethra was also easily visible. Moreover, it was possible to depict the rhabdosphincter muscle and observe its variability among the examined subjects. Colour Doppler showed vascular patterns.
    CONCLUSION:
    A novel 3D-endovaginal ultrasound is very valuable imagining technique in the assessment of urethral complex and bladder neck morphology in females and may become a very important tool in early diagnostics of SUI.