Evaluation of lower urinary tract structure and predictive value of urinary incontinence in patients with pelvic organ prolapse after operation with four-dimensional ultrasound of pelvic floor
Objective To analyze the risk factors of post-operative stress urinary incontinence(SUI)in patients with pelvic organ prolapse(POP),and the value of pelvic floor four-dimensional ul-trasound in evaluating the structure of lower urinary tract and predicting urinary incontinence.Methods A total of 136 cases POP patients treated in our hospital from June 2018 to June 2020 with no diagnosis of urinary incontinence before surgery were selected as the study objects.According to whether they had new SUI after operation,the patients were divided into no postoperative SUI group(94 cases)and new postoperative SUI group(42 cases).The lower urinary tract structure of the patients before and after surgery was observed by four-dimensional ultrasound of the pelvic floor,and the risk factors of new postoperative SUI in POP patients were analyzed by univariate and multivariate logistic regression.Build a nomogram model and make predictions.Results The degree of bladder neck movement after operation was significantly lower than that before operation(P＜0.05).During maximum Valsalva,the postoperative levator anal space and urethral rotation angle were significantly reduced compared with those before operation(all P＜0.05).Patients with a history of diabetes mellitus,giant fetal de-livery history,V-bladder neck mobility,V-urethral rotation angle,V-levator anal space and urethral space in the newly diagnosed SUI group were significantly higher than those in the group without new SUI,and the proportion of history of pelvic surgery was lower than that of the group without new SUI(all P＜0.05).Multivariate results showed that the lower urinary tract structure observation indexes(V-bladder neck mobility,V-urethral rotation angle,V-levator anal space),as well as the history of giant fetus delivery,diabetes and pelvic surgery were risk factors for new postoperative SUI(all P＜0.05).There was no collinearity between the factors.The nomogram prediction model has good differ-entiation,accuracy and effectiveness.Conclusions The use of pelvic floor four-dimensional ultra-sound can indeed have a clearer understanding of the lower urinary tract structure of patients after sur-gery,which has a very important predictive value for the symptoms of postoperative SUI,and is worthy of clinical application.
Pelvic Organ ProlapseFour-Dimensional Computed TomographyUrinary Inconti-nence
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