Study of pelvic floor muscle strain rate in postpartum patients with stress urinary incontinence by perineal 4D ultrasound
Objective:To study the structure and function of pelvic floor using 4D perineal ultrasonography,and to provide quantitative parameters and objective basis for the diagnosis of early postpartum stress urinary incontinence(SUI).Methods:A total of 30 women with SUI symptoms 42 to 100 days after dilivery were collected from the Second Affiliated Hospital of Baotou Medical College as the case group(SUI group),and 30 women without SUI symptoms in the same period as the control group(non-SUI group).Bladder neck mobility(BNM),urethral rotation angle(URA)and posterior bladder angle(RVA)were measured under different conditions,and the strain rate of levator ani muscle was calculated for analysis and comparison.The cut-off value of ultrasonic diagnosis was obtained by drawing the re-ceiver operating characteristic curve(ROC).Results:There was no significant difference in general data between the two groups(P<0.05).The area shrinkage strain rate(εA1)in both SUI and non-SUI groups was positively correla-ted with the perimeter shrinkage strain rate(εC1)(r=0.617,P<0.01;r=0.457,P<0.05).The εC1 of both groups was positively correlated with the strain rate of diameter shrinkage(εL1)(r=0.569,P<0.01;r=0.563,P<0.01).The average area tensile strain rate(εA2)of the two groups was positively correlated with perimeter tensile strain rate(εC2)(r=0.370,P<0.01;r=0.647,P<0.01)and tensile strain rate(εL2)(r=0.663,P<0.01;r=0.427,P<0.01).εC2 in the two groups was both positively correlated with εL2(r=0.785,P<0.01;r=0.542,P<0.01).The ROC curve showed that εA1 had the best diagnostic cutoff,the largest area under the curve(0.993 6),and the highest sensitivity(97.4%).Conclusion:The strain rate of levator ani muscle contraction is val-uable in the diagnosis of early postpartum SUI.
Stress incontinenceEarly postpartum periodPelvic floor structure and functionTransperineal 4D ul-trasoundStrain rate of levator ani muscle