scholarly journals Real-time assessment of the behaviour of the bladder neck and proximal urethra during urine leaking in the cough stress test (CST) in supine and standing positions using transperineal ultrasound

2020 ◽  
Vol 31 (12) ◽  
pp. 2515-2519
Author(s):  
Lieming Wen ◽  
Baihua Zhao ◽  
Wenjie Chen ◽  
Zhenzhen Qing ◽  
Minghui Liu

Abstract Introduction and hypothesis The objective was to describe the behaviour of the bladder neck and proximal urethra during urine leaking in the cough stress test (CST) in supine and standing positions using transperineal ultrasound (TPUS). Method We carried out prospective data collection and a retrospective data analysis of 102 women with stress urinary incontinence (SUI) who had a positive CST with TPUS in the supine and/or standing position. On TPUS, the behaviour of the bladder neck and proximal urethra was described by the urethral length, urethral funnelling, bladder neck descent (BND), retrovesical angle (RVA) and urethral rotation angle (URA). Differences between the ultrasound findings in the two positions were evaluated. Results In the 102 women, the mean age was 48 years and mean BMI was 23.8 kg/m2. On TPUS, urine leakage was detected in the supine or standing position in 102 women and in both positions in 81. Between the two positions, significant differences were found in the URA and RVA. In the standing position, the median RVA of 166° was significantly larger than that of 133° in the supine position (p < 0.001), and the median URA of 35° was significantly smaller than that of 64° in the supine position (p < 0.001). Conclusions TPUS in both positions can be used to detect the real-time behaviour of the bladder neck and urethra in the CST. In the standing position, less rotation and more straightening of the bladder neck and proximal urethra occurred during urine leakage.

Author(s):  
Ahmed El lithy

Stress urinary incontinence (SUI) has an observed prevalence of between 4%and 35%. Purpose: To determine the role of transperineal ultrasound in diagnosing stress incontinence, its degree and the possible cause by: Measuring the BN descent, urethral hypermobility, funneling of BN or proximal urethra, urethral diameter, posterior urethra vesical angle, associated cystocele Using color Doppler to detect escape of urine through the urethra. Methods: 52 female patients diagnosed to have genuine stress incontinence using 3 day voiding diary, simple questionnaire and confirmed by standard urodynamics. Classification of stress incontinence into mild, moderate and severe using Valsalva leak point pressure during urodynamic study. Transperineal ultrasound for evaluation of the anterior pelvic compartment regarding: bladder neck descent, urethralhy permobility, Funneling of the BN, posterior urethrovesical angle ,urethral diameter, associatedcystocele, and finally the Doppler detection of urinary escape both at rest and with Valsalva maneuvers. Results: 28/52 cases (53.8%) of SUI didn’t show clinical evidence of cystocele; 11 cases (21.2%) showed grade 1 cystocele and 13cases (25%) showed grade 2 cystocele. The presence or absence of cystocele and also the grade of cystocele did not show a statistically significant relation to the degree of SUI; p=0.089 and 0.086 respectively Conclusion: We came to conclusion that transperineal ultrasound can be used in accurate diagnosis and grading of female urinary stress incontinence with our given cutoff values for bladder displacement, α angle, β angle and urethral diameters and from this grading by transperineal ultrasound comes the novelity of our research.


2021 ◽  
pp. 1-10
Author(s):  
Xia Jiang ◽  
Li Li ◽  
Hong-Yuan Xue

BACKGROUND: In the past ten years, liver biopsies have been used as a method to accurately diagnose the stage of fibrosis. OBJECTIVE: This study aimed to evaluate whether body position and exercise affect the measurement of liver Young’s modulus of healthy volunteers by real-time shear wave elastography (RT-SWE). Methods: RT-SWE was used to measure liver Young’s modulus in the supine and left lateral positions of 70 healthy volunteers at rest and measure the liver Young’s modulus in the lying position before exercise, and at zero, five, and ten minutes of rest after exercise. RESULTS: The liver Young’s modulus in the left lateral position was significantly higher than in the supine position (P< 0.05), and the measured value in the supine position was more stable than the left lateral position. The liver Young’s modulus measured at zero minutes after exercise was significantly higher than that measured before exercise (P< 0.05). The liver Young’s modulus measured at five minutes after exercise was significantly higher than that measured at zero minutes after exercise (P<0.05) and was not statistically different from the measured value before exercise (P> 0.05). The liver Young’s modulus measured at ten minutes after exercise was significantly higher from that measured at zero minutes after exercise (P< 0.05) and was not statistically different from the measured value at five minutes after exercise (P> 0.05). CONCLUSION: Body position and exercise have a significant impact on the measurement of liver Young’s modulus. It is recommended that the examinees take a supine position during the measurement, and measurement should be conducted at least ten minutes after exercise.


1989 ◽  
Vol 160 (1) ◽  
pp. 182-185 ◽  
Author(s):  
David Gordon ◽  
Malcolm Pearce ◽  
Peggy Norton ◽  
Stuart L. Stanton

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yuki Yoshida ◽  
Noboru Matsumura ◽  
Yoshitake Yamada ◽  
Minoru Yamada ◽  
Yoichi Yokoyama ◽  
...  

Abstract Background Narrowing of the acromiohumeral distance (AHD) implies a rotator cuff tear. However, conventional AHD measurements using two-dimensional (2D) imaging or with the patient in the supine position might differ from that while standing during daily activity. This study aimed to evaluate the three-dimensional (3D) actual distance between the acromion and humeral head in the standing position and compare the AHD values with those obtained using conventional measuring methods. Methods Computed tomography (CT) images of 166 shoulders from 83 healthy volunteers (31 male and 52 female; mean age 40.1 ± 5.8 years; age range, 30–49 years) were prospectively acquired in the supine and standing positions using conventional and upright CT scanners, respectively. The minimum distance between the acromion and humeral head on the 3D surface models was considered as the 3D AHD. We measured the 2D AHD on anteroposterior digitally reconstructed radiographs. The AHD values were compared between the supine and standing positions and between the 2D and 3D measurements. Results The mean values of 2D AHD were 8.8 ± 1.3 mm (range, 5.9–15.4 mm) in the standing position and 8.1 ± 1.2 mm (range, 5.3–14.3 mm) in the supine position. The mean values of 3D AHD were 7.3 ± 1.4 mm (range, 4.7–14.0 mm) in the standing position and 6.6 ± 1.2 mm (range, 4.4–13.7 mm) in the supine position. The values of 3D AHD were significantly lower than those of 2D AHDs in both the standing and supine positions (P < 0.001). The values of 2D and 3D AHDs were significantly lower in the supine position than in the standing position (P < 0.001). Conclusions This study evaluated the 3D AHD of normal shoulders in the standing position using an upright CT scanner. The present results indicated that assessments in the supine position can underestimate the value of the AHD compared with those made in the standing position and that assessments using 2D analysis can overestimate the value.


Sign in / Sign up

Export Citation Format

Share Document