Translabial color Doppler for imaging in urogynecology: a preliminary report

Objective A prospective study was conducted to evaluate the use of color Doppler ultrasound in the investigation of female urinary incontinence. Methods Thirty-seven patients underwent a full urodynamic assessment and translabial ultrasound examination using color Doppler-capable equipment with 5-7-MHz curved array transducers, both in the supine and in the erect positions. Results More than minimal leakage was seen in 13 patients by Doppler and in 16 by fluoroscopic imaging. Results were in agreement in 28/37 cases (kappa 0.49). The observed discrepancies may have been due to initial technical difficulties, differences in bladder filling and the presence of a catheter an fluoroscopic imaging. In five incontinent patients, urethral flow velocities ranged from 0.064 to 0.34 m/s, which is equivalent to physiological venous and slow arterial blood flow and one to two orders of magnitude above the detection threshold of standard Doppler ultrasound equipment. Conclusions Translabial color Doppler imaging of the lower urinary tract allows the documentation of fluid leakage from the bladder. It has the potential to become the new imaging standard for urogynecology.