Dose a Bladder Volume of 200 mL Generate Greater Urethral Mobility at Valsalva Movement in Female Patients with Stress Urinary Incontinence?

Background: Failure to standardize bladder volume in the evaluation of stress urinary incontinence (SUI) may be a contributing factor to the controversy surrounding the diagnostic and prognostic efficacy of urodynamic studies (UDS) in female patients with SUI. This study was condu...

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Main Authors: Ning Xiao, Li Gao, Xiangxi Yao, Xiaohua Gao, Qi Tang, Gaoyu Pan, Kailu Wei, Huasheng Zhao, Jianfeng Wang
Format: Article
Language:English
Published: IMR Press 2024-12-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/51/12/10.31083/j.ceog5112265
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author Ning Xiao
Li Gao
Xiangxi Yao
Xiaohua Gao
Qi Tang
Gaoyu Pan
Kailu Wei
Huasheng Zhao
Jianfeng Wang
author_facet Ning Xiao
Li Gao
Xiangxi Yao
Xiaohua Gao
Qi Tang
Gaoyu Pan
Kailu Wei
Huasheng Zhao
Jianfeng Wang
author_sort Ning Xiao
collection DOAJ
description Background: Failure to standardize bladder volume in the evaluation of stress urinary incontinence (SUI) may be a contributing factor to the controversy surrounding the diagnostic and prognostic efficacy of urodynamic studies (UDS) in female patients with SUI. This study was conducted to explore the effects of bladder volume on the urethral mobility in female patients with SUI under increased intra-abdominal pressure. Methods: This prospective study enrolled uncomplicated female patients with SUI admitted to the Second Affiliated Hospital of Guilin Medical University and Shaoyang Central Hospital, between January 2021 and January 2024. Relative bladder neck descent (BND), urethral inclination angle (UTA), urethral rotation angle (URA), and posterior urethrovesical angle (PUVA) were compared across different bladder volumes (100 mL, 200 mL, and 300 mL) at resting state or 90 cm H2O of intravesical pressure, generated by Valsava movement, using sonography videourodynamic studies (SVUDS). Analysis of variance (ANOVA) was used to compare numerical data of parameters with a normal distribution. Results: 62 patients were enrolled in this study. There was not a significant difference in UTA and PUVA among the various bladder volumes (100 mL, 200 mL, and 300 mL) at resting state (all p >0.05). However, higher BND (2.23 ± 0.73 cm), UTA (44.7 ± 17.1°), URA (29.4 ± 16.0°), and PUVA (148.7 ± 21.4°) were determined at a bladder volume of 200 mL with the Valsalva movement (VM) reaching 90 cm H2O of intravesical pressure, compared to 100 mL (1.89 ± 0.74 cm, 38.1 ± 17.9°, 23.0 ± 15.5°, and 139.3 ± 19.8°) and 300 mL (1.85 ± 0.74 cm, 37.6 ± 18.8°, 23.8 ± 13.5°, and 143.4 ± 20.8°) (all p <0.05), except for PUVA between 200 mL and 300 mL (p = 0.161). Conclusions: Higher values of BND, UTA, URA, and PUVA at a bladder volume of 200 mL in the Valsalva state of female patients with SUI, compared to 100 mL and 300 mL, suggest that capacity of 200 mL should be standardized for evaluating female SUI.
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spelling doaj-art-bc574534448a4d4aa89dff2e67c6d1392025-08-20T03:23:18ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632024-12-01511226510.31083/j.ceog5112265S0390-6663(24)02522-3Dose a Bladder Volume of 200 mL Generate Greater Urethral Mobility at Valsalva Movement in Female Patients with Stress Urinary Incontinence?Ning Xiao0Li Gao1Xiangxi Yao2Xiaohua Gao3Qi Tang4Gaoyu Pan5Kailu Wei6Huasheng Zhao7Jianfeng Wang8Videourodynamic Studies Center, Department of Urology, The Second Affiliated Hospital of Guilin Medical University, 541199 Guilin, Guangxi, ChinaSchool of Pharmacy, Macau University of Science and Technology, 999078 Macau, ChinaDepartment of Urology, Guilin Hospital of the Second Xiangya Hospital, Central South University, 541001 Guilin, Guangxi, ChinaDepartment of Operation Room, The Second Affiliated Hospital of Guilin Medical University, 541199 Guilin, Guangxi, ChinaVideourodynamic Studies Center, Department of Urology, The Second Affiliated Hospital of Guilin Medical University, 541199 Guilin, Guangxi, ChinaVideourodynamic Studies Center, Department of Urology, The Second Affiliated Hospital of Guilin Medical University, 541199 Guilin, Guangxi, ChinaVideourodynamic Studies Center, Department of Urology, The Second Affiliated Hospital of Guilin Medical University, 541199 Guilin, Guangxi, ChinaContinence Research Clinic, Department of Urology, Shaoyang Central Hospital, 422000 Shaoyang, Hunan, ChinaContinence Research Clinic, Department of Urology, Shaoyang Central Hospital, 422000 Shaoyang, Hunan, ChinaBackground: Failure to standardize bladder volume in the evaluation of stress urinary incontinence (SUI) may be a contributing factor to the controversy surrounding the diagnostic and prognostic efficacy of urodynamic studies (UDS) in female patients with SUI. This study was conducted to explore the effects of bladder volume on the urethral mobility in female patients with SUI under increased intra-abdominal pressure. Methods: This prospective study enrolled uncomplicated female patients with SUI admitted to the Second Affiliated Hospital of Guilin Medical University and Shaoyang Central Hospital, between January 2021 and January 2024. Relative bladder neck descent (BND), urethral inclination angle (UTA), urethral rotation angle (URA), and posterior urethrovesical angle (PUVA) were compared across different bladder volumes (100 mL, 200 mL, and 300 mL) at resting state or 90 cm H2O of intravesical pressure, generated by Valsava movement, using sonography videourodynamic studies (SVUDS). Analysis of variance (ANOVA) was used to compare numerical data of parameters with a normal distribution. Results: 62 patients were enrolled in this study. There was not a significant difference in UTA and PUVA among the various bladder volumes (100 mL, 200 mL, and 300 mL) at resting state (all p >0.05). However, higher BND (2.23 ± 0.73 cm), UTA (44.7 ± 17.1°), URA (29.4 ± 16.0°), and PUVA (148.7 ± 21.4°) were determined at a bladder volume of 200 mL with the Valsalva movement (VM) reaching 90 cm H2O of intravesical pressure, compared to 100 mL (1.89 ± 0.74 cm, 38.1 ± 17.9°, 23.0 ± 15.5°, and 139.3 ± 19.8°) and 300 mL (1.85 ± 0.74 cm, 37.6 ± 18.8°, 23.8 ± 13.5°, and 143.4 ± 20.8°) (all p <0.05), except for PUVA between 200 mL and 300 mL (p = 0.161). Conclusions: Higher values of BND, UTA, URA, and PUVA at a bladder volume of 200 mL in the Valsalva state of female patients with SUI, compared to 100 mL and 300 mL, suggest that capacity of 200 mL should be standardized for evaluating female SUI.https://www.imrpress.com/journal/CEOG/51/12/10.31083/j.ceog5112265female stress urinary incontinenceurethral mobilitybladder volumevalsalva movementsonography videourodynamic studies
spellingShingle Ning Xiao
Li Gao
Xiangxi Yao
Xiaohua Gao
Qi Tang
Gaoyu Pan
Kailu Wei
Huasheng Zhao
Jianfeng Wang
Dose a Bladder Volume of 200 mL Generate Greater Urethral Mobility at Valsalva Movement in Female Patients with Stress Urinary Incontinence?
Clinical and Experimental Obstetrics & Gynecology
female stress urinary incontinence
urethral mobility
bladder volume
valsalva movement
sonography videourodynamic studies
title Dose a Bladder Volume of 200 mL Generate Greater Urethral Mobility at Valsalva Movement in Female Patients with Stress Urinary Incontinence?
title_full Dose a Bladder Volume of 200 mL Generate Greater Urethral Mobility at Valsalva Movement in Female Patients with Stress Urinary Incontinence?
title_fullStr Dose a Bladder Volume of 200 mL Generate Greater Urethral Mobility at Valsalva Movement in Female Patients with Stress Urinary Incontinence?
title_full_unstemmed Dose a Bladder Volume of 200 mL Generate Greater Urethral Mobility at Valsalva Movement in Female Patients with Stress Urinary Incontinence?
title_short Dose a Bladder Volume of 200 mL Generate Greater Urethral Mobility at Valsalva Movement in Female Patients with Stress Urinary Incontinence?
title_sort dose a bladder volume of 200 ml generate greater urethral mobility at valsalva movement in female patients with stress urinary incontinence
topic female stress urinary incontinence
urethral mobility
bladder volume
valsalva movement
sonography videourodynamic studies
url https://www.imrpress.com/journal/CEOG/51/12/10.31083/j.ceog5112265
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