Reliability of real-time ultrasound to detect pelvic floor muscle contraction in urinary incontinent women.

Full Abstract

PURPOSE: We determined the reliability of real-time ultrasound for detecting involuntary or reflex pelvic floor muscle contraction. MATERIALS AND METHODS: A total of 118 women with the symptomatic and urodynamic evidence of stress urinary incontinence were recruited in a 3-year period from tertiary referral urogynecology clinics. Under the oral instruction of strong coughing involuntary pelvic floor muscle contraction was detected using introital ultrasound in real-time and cine loop modes. Two dynamic imaging features were considered involuntary pelvic floor muscle contraction, including an inward clitoral motion and a superior-anterior anorectal lift before or during coughing. RESULTS: Real-time ultrasound had good reliability to detect involuntary pelvic floor muscle contraction. For interobserver and intra-observer reliability Cohen's kappa was 0.645 to 0.679. Of the 118 women real-time ultrasound before or during coughing showed an inward clitoral motion in 100 (93%) and an anorectal lift in 108 (92%). Neither type of contraction during coughing was identified in 2 women. Although the 2 contraction patterns were synchronized in 88% of women, for this synchronization kappa was only 0.159, indicating poor coordination between these 2 involuntary activities. CONCLUSIONS: Real-time ultrasound is a reliable tool for detecting involuntary pelvic floor muscle contraction.

Author information

Author/s: Yang, Jenn-Ming (JM); Yang, Shwu-Huey (SH); Yang, Shu-Yu (SY); Yang, Evelyn (E); Huang, Wen-Chen (WC);

Affiliation: Division of Urogynecology, Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, Republic of China.

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: The Journal of urology (J Urol), published in United States. (Language: eng)

Reference: 2009-Nov; vol 182 (issue 5) : pp 2392-6

Dates: Created 2009/10/12; Completed 2009/10/30;

PMID: 19781720, status: MEDLINE (last retrieval date: 10/30/2009, IMS Date: )

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