Transperineal pelvic floor ultrasound parameters combined with rectus abdominis separation can improve the diagnostic efficacy of postpartum stress urinary incontinence
BAI Weiwei
LIAO Fan
KAN Xiaochun
ZHU Meidi
Abstract：Objective To investigate the value of transperineal pelvic floor ultrasound parameters combined with rectus abdominis separation in the evaluation of postpartum stress urinary incontinence(PSUI).Methods The clinical data of 112 parturients who gave birth in our hospital from September 2022 to August 2024 and underwent postpartum reexamination 6-8 weeks after delivery were included.According to the occurrence of PSUI,the postpartum women were divided into PSUI group(n=51)and non-PSUI group(n=61).Transperineal pelvic floor ultrasound parameters[bladder neck position at rest(BSD1),urethral inclination angle(UIA1),posterior vesicourethral angle(PUA1),levator hiatus area(LHA1)]of all postpartum women were collected.Bladder neck position(BSD2),urethral inclination angle(UIA2),posterior vesicourethral angle(PUA2),levator hiatus area(LHA2),funnel formation rate of internal urethral orifice during maximum Valsava maneuver,bladder neck mobility(BND)and urethral rotation angle(URA)]and rectus abdominis separation were measured.Logistic regression was used to analyze the independent risk factors of PSUI,and the ROC curve was drawn to verify the diagnostic efficacy of each parameter alone and in combination for PSUI.Results The BSD2,UIA2,PUA2,LHA2,urethral funnel formation rate,BND and URA in the PSUI group were higher than those in the non-PSUI group(P<0.05).Of the 112 postpartum women,28 had normal rectus abdominis,of which 7 had PSUI(25.00%).In 43 cases of mild separation group,PSUI occurred in 14 cases(32.56%).In the moderate separation group of 27 cases,19 cases had PSUI(70.37%);there were 14 cases in the severe separation group,and 11 cases(78.57%)had PSUI.With the aggravation of rectus abdominis separation,the incidence of PSUI increased gradually(P<0.05).Logistic regression analysis showed that LHA2(OR=3.170),urethral funnel formation rate(OR=2.702),BND(OR=3.034),URA(OR=2.854)and rectus abdominis separation(OR=3.476)were independent risk factors for PSUI(P<0.05).ROC curve showed that the AUC was 0.925 when the parameters were combined,the sensitivity and specificity were 84.31%and 86.89%,respectively.Conclusion The diagnostic efficacy of PSUI can be further improved by transperineal pelvic floor related ultrasound parameters LHA2,urethral funnel formation rate,BND and URA combined with rectus abdominis separation.
Keywords：postpartum stress urinary incontinencetransperinealultrasound examinationthe separation degree of rectus abdominisdiagnostic performance
Publication Date：2025-03-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 340-346 )