Abstract
The effect of babies >3500 g primimultiparity, previous forceps deliveries, obesity and stress urinary incontinence on urethrovesical junction mobility (UVJ) was determined by the Q-tip test in 440 women divided into four groups according to age. The urethral axis under stress (UAS) for these different categories of patient compared to corresponding nulliparous patients (49°±21) demonstrates an increasing statistically significant difference in UVJ mobility in primiparas (56°±21), multiparas (58°±19), patients with previous forceps delivery (59°±21) and with deliveries of babies >3500 g (61°±17). Surprisingly, obesity does not affect UVJ mobility. Except for postmenopausal women, assessment of UAS in patients with GSI by history demonstrates a 5° higher UVJ mobility compared to continent patients (a 10° higher UVJ mobility was found in a fifth group of clinically proven GSI patients). When considering UAS distribution in the four groups, only 6%–33% of nulliparas have a ‘normal’ UAS of <30°, and 20% of young nulliparous patients have an UVJ hypermotility of >60°, demonstrating perhaps an increased risk of future GSI.
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Meyer, S., De Grandi, P. & Schmidt, N. The urethral axis during stress. Int Urogynecol J 4, 14–18 (1993). https://doi.org/10.1007/BF00372802
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DOI: https://doi.org/10.1007/BF00372802