Construction of an integrated pelvic floor 4D ultrasound multiparameter model and its diagnostic value for postpartum stress urinary incontinence
HUANG Rong
ZHANG Qianxi
LIU Yuxin
ZENG Yan
FU Zhongdai
LIANG Ruitian
XU Xiaoyan
Abstract：Objective To construct a predictive model for postpartum stress urinary incontinence(PSUI)based on clinical data and pelvic floor 4D ultrasound parameters,and to validate the model's diagnostic efficacy and calibration accuracy.Methods Thirty-six patients with postpartum PSUI(study group)and 36 women with a history of childbirth but no postpartum PSUI(control group)were selected.Baseline data including age,Body Mass Index(BMI),and history of vaginal delivery were collected from both groups.All participants underwent pelvic floor 4D ultrasound examination to obtain dynamic parameters,in terms of bladder neck mobility,descent distance of the posterior bladder wall,incidence of proximal urethral orifice funneling,retrovesical angle,urethral inclination angle,urethral rotation angle,and levator hiatal area.Variables with statistically signifi-cant differences between groups were screened by univariate analysis and were subsequently included in a multivariate Logistic regression analysis to construct a predictive model for PSUI.The predictive performance of the model was evaluated using the re-ceiver operating characteristic(ROC)curve,and the calibration accuracy was verified by the calibration curve.Results Com-pared with the control group,the study group showed increases in age,BMI,bladder neck mobility,descent distance of the pos-terior bladder wall,incidence of proximal urethral orifice funneling,retrovesical angle,urethral inclination angle,urethral rota-tion angle,and levator hiatal area(all P<0.05).Multivariate Logistic regression analysis indicated that age,BMI,bladder neck mobility,descent distance of the posterior bladder wall,incidence of proximal urethral orifice funneling,retrovesical angle,ure-thral inclination angle,urethral rotation angle,and levator hiatal area were independent risk factors for PSUI(all P<0.05).Based on these independent risk factors,a nomogram model for the individualized prediction of PSUI risk was successfully con-structed.This model demonstrated the highest diagnostic efficacy(AUC=0.989),which was superior to all single parameters(all P<0.05).The calibration curve indicated a good fit between the predicted probabilities of the model and the actual observed prob-abilities.Conclusion A predictive model for PSUI is successfully constructed based on clinical data and pelvic floor 4D ultra-sound parameters.This model exhibits superior predictive performance for PSUI compared to any single parameter and maintains good calibration accuracy across the overall risk distribution.
Keywords：Postpartum stress urinary incontinencepelvic floor 4D ultrasoundIntegrated multiparameter modelDiagnos-tic efficacy
Publication Date：2025-12-30
Online Publishing Date：2026-02-04(First online date of this platform, not the publication date of the document)
Pages：6( 108-113 )