Evaluation of urethrovesical angle by ultrasound in women with and without urinary stress incontinence

Our aim was to investigate the role of ultrasonographic imaging in the evaluation of genuine stress incontinence (GSI). The posterior urethrovesical angles (PUVA) of each of 50 incontinent (group I) and 50 control cases (group C) were measured by both transperineal and transvaginal ultrasonography (TP-USG, TV-USG). In group I the angles were 94.9 +/- 10.9 at rest and 102.7 +/- 16.1 by TP-USG (P<0.001), and 100.6 +/- 11.1 at rest and 103.3 +/- 9.6 during Valsalva by TV-USG (not significant). In the control group these measurements were 93 +/- 5.3, 96.2 +/- 7.9 (P<0.001) and 98 +/- 8.8, 101.1 +/- 10.3 (P=0.001) by TV-USG, respectively. The degree of alteration of the angle, originating with Valsalva maneuver (Delta-PUVA) was 7.7 +/- 11.8 in group I and 3.2 +/- 4.95 in group C (P=0.014) by TP-USG, and 2.7 +/- 11.8 and 3.2 +/- 6.16 by TV-USG (NS). Our data reveal that PUVA and Delta-PUVA have important roles in GSI pathophysiology: however, ultrasonography, especially by the transvaginal route, cannot be a reliable useful method as a diagnostic tool in the evaluation of GSI.