Post-partum introital sonography of the lower urinary tract

Methods: Introital sonography was performed on 131 patients between the first and 13th day (average 4.2 days) after delivery. 41 non-pregnant nulliparous women without any complaints of urinary incontinence served as controls. Post-partum morphological changes were analysed using a 5-MHz vaginal scanner and correlated with parity and mode of delivery. Results: The occurrence of cystoceles and opening of the proximal urethra were strongly related with parity and mode of delivery being more common in multiparous women after vaginal deliveries than after caesarean sections. In the control group, the urethrovesical angle beta was 96 degrees in rest and 102 degrees when straining. After vaginal deliveries, a significantly larger angle was observed when compared to patients after caesarean section. During straining, the bladder neck shortened from 21.4 mm to 13.1 mm compared to -0.7 mm after vaginal delivery. Conclusion: Morphological changes of the lower urinary tract after delivery are common. The sonographic appearance of these changes is almost identical to those observed in patients with urinary stress incontinence.