Particle Swarm Algorithm-Based Analysis of Pelvic Dynamic MRI Images in Female Stress Urinary Incontinence

This work aimed to study the application of pelvic floor dynamic images of magnetic resonance imaging (MRI) based on the particle swarm optimization (PSO) algorithm in female stress urinary incontinence (SUI). 20 SUI female patients were selected as experimental group, and another 20 healthy females were taken as controls. PSO algorithm, K-nearest neighbor (KNN) algorithm, and back propagation neural network (BPNN) algorithm were adopted to construct the evaluation models for comparative analysis, which were then applied to 40 cases of female pelvic floor dynamic MRI images. It was found that the model proposed had relatively high prediction accuracy in both the training set (87.67%) and the test set (88.46%). In contrast to the control group, there were considerable differences in abnormal urethral displacement, urethral length changes, bladder prolapse, and uterine prolapse in experimental patients ( P < 0.05 ). After surgery, the change of urethral inclination angle was evidently reduced ( P < 0.05 ). To sum up, MRI images can be adopted to assess the occurrence of female SUI with abnormal urethral displacement, shortening of urethra length, bladder prolapse, and uterine prolapse. After surgery, the abnormal urethral movement was slightly improved, but there was no obvious impact on bladder prolapse and uterine prolapse.

Does Dominant Prolapse in Other Compartments Affect the Assessment of Bladder Prolapse on Translabial Ultrasound?

Objective: To explore the impact of dominant prolapse in other compartments in assessing bladder prolapse, and to establish cutoffs for staging bladder prolapse among Chinese women using translabial ultrasound. Design: Prospective multicentre observational study. Setting: Tertiary referral urogynaecology unit. Population: A total of 741 women with symptoms of lower urinary tract dysfunction and/or pelvic floor dysfunction were included. Methods: Women underwent interview, pelvic organ prolapse quantification (POP-Q) examinations and 4D translabial ultrasounds. Main outcome measures: The ROC statistic was used to assess accuracy and define the optimal cutoffs. Results: The mean patient age was 42.7 years (range, 18-82). There were 456 women without dominant prolapse in the apical/posterior compartments and 285 women with dominant prolapse in the apical/posterior compartments. Among patients without and with dominant prolapse, similar cutoffs (-10.9 mm vs. -9.1 mm) were determined for predicting POP-Q stage ≥ 2 in the anterior compartment, with AUCs of 0.87 and 0.79, respectively. In contrast, significantly different cutoffs (-5.7 mm vs. +3.5 mm) were determined for predicting POP-Q stage ≥ 1 among patients with and without dominant prolapse, with AUCs of 0.85 and 0.77, respectively. Conclusion: Dominant prolapse in the apical/posterior compartments affected the accuracy and cutoffs of translabial ultrasound for staging bladder prolapse. Thus, competition of various organs in women with multi-compartment prolapse should be considered as a potential complicating factor in assessing pelvic organ prolapse. Funding: The study is supported by grants from the National Natural Science Foundation of China (No. 91859115). Key words: Bladder prolapse; translabial ultrasound.

Adoption of Pelvic Floor Ultrasonography Under Fuzzy Theory and Wavelet Transform Algorithm in Subtype Diagnosis of Bladder Prolapse

In order to improve the treatment accuracy of patients with different subtypes of bladder prolapse (BP), the value of ultrasonic images based on fuzzy theory (FT) and wavelet transform (WT) algorithm for detection and classification of subtypes of BP was discussed. First, the effects of fuzzy enhancement (FE) algorithm, WT enhancement algorithm, and FT combined wavelet algorithm on medical ultrasonic images were compared. Then, 144 cases of BP patients admitted to our hospital from October 2017 to October 2019 were selected as study objects. Ultrasound technology was used to examine the patient's bottom information. Finally, the data of posterior urethra-vesical angle (PUVA), rotation angle (RA) of urethra, mobility of bladder neck, lowest point of bladder and lowest point of posterior wall of bladder were measured under resting and Vslsalva conditions. According to Green classification, different subtypes of bladder prolapse were distinguished by the measurement data of pelvic floor (PF) ultrasound image. The clinical characteristics of Stress Urinary Incontinence (SUI), dysuria, and frequent urination of subtypes of BP were compared. The results showed that the ultrasonic image quality was the best by combining FT with WT; BP type II PUVA was more than 140°, BP type III PUVA was less than 140°, and the difference between the two was statistically significant (P < 0.05); the lowest point of the bladder in patients with type III BP was significantly higher than that in patients with type II BP (P < 0.05), and the neck mobility of type III bladder and the lowest point of the posterior wall of the bladder were significantly lower than that in patients with type II BP (P < 0.05); the difference of urethral RA between type II and type III of BP was not statistically significant (P > 0.05); the incidence of SUI in patients with type II BP was higher than that of type III BP (P < 0.05), and the incidence of dysuria in patients with type III BP was higher than that of type II BP (P < 0.05); the incidence of urinary frequency in patients with type II and type III BP was not statistically significant (P > 0.05), which showed that PF ultrasound based on FT and WT algorithm could effectively detect and identify different subtypes of BP.

Transurethral urinary bladder eversion and prolapse in a castrated male pet rabbit

A 7-year-old castrated male rabbit was presented with a red oedematous mass at the prepuce. The tissue was identified as the urinary bladder, and the condition was diagnosed as complete transurethral urinary bladder eversion. Exploratory laparotomy was performed, the prolapse was successfully reduced and the bladder was secured to the body wall with cystopexy. The surgery was successful and the bladder remained in place without complications until the time of this report (three years after surgery). Transurethral bladder prolapse is a very rare condition previously reported only in women, mares, cows, bitches, queens, and rabbit does. The case herein is the first reported case of transurethral bladder prolapse in a male of any species.