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Comparison of urethral parameters in females presenting cystoceles with and without stress urinary incontinence based on dynamic magnetic resonance imaging: are they different?

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Abstract

Purpose

To compare urethral parameters between cystocele patients with and without stress urinary incontinence (SUI) and explore factors influencing SUI in cystocele patients via dynamic MRI.

Methods

The two-dimensional parameters evaluated included the paravaginal defects, levator ani muscle defects, urethral length, urethral funnel shape, bladder neck funnel width, bladder neck funnel depth, urethral angle, posterior vesicourethral angle, and anterior bladder protrusion. The three-dimensional parameters included the proximal urethra rotation angle, the distal urethra rotation angle, bladder neck mobility, urethral midpoint mobility, and external urethral meatus mobility. The independent samples t test was used for continuous variables, and the chi-square test was used for categorical variables. Binary logistic regression was used to identify factors independently associated with SUI in cystocele patients.

Results

The baseline parameters were similar between the 2 groups. Cystocele patients with SUI had a significantly higher point Aa (1.63 ± 1.06 cm vs. 0.81 ± 1.51 cm, p = 0.008); more anterior bladder protrusion (33.3% vs. 11.4%, p = 0.017); greater bladder neck mobility (36.38 ± 11.46 mm vs. 28.81 ± 11.72 mm, p = 0.005); mid-urethral mobility (22.94 ± 6.50 mm vs. 19.23 ± 6.65 mm, p = 0.014); and external urethral meatus mobility (22.42 ± 8.16 mm vs. 18.03 ± 8.51 mm, p = 0.022) than did cystocele patients without SUI. The other urethral parameters were similar in the groups (p > 0.05). Binary logistic regression showed that bladder neck mobility was independently associated with SUI in females with cystoceles (odds ratio, 1.06; 95% CI 1.015–1.107; p = 0.009).

Conclusion

Cystocele patients with SUI have a higher point Aa, more anterior bladder protrusion, and greater urethral mobility than those without SUI. Bladder neck mobility is independently associated with SUI in females with cystoceles.

Registration number: NCT03146195.

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Acknowledgements

We appreciate the Department of Radiology, Nanfang Hospital of Southern Medical University, for technical support. The study was supported by the National Natural Science Foundation of China (Grant No. 81571422) and the basic and Applied basic research project of Guangzhou Municipal Science and Technology Bureau (202201011337).

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China

    Lian Tang

  2. Department of Obstetrics and Gynecology, NanFang Hospital, Southern Medical University, North of Guangzhou Avenue, No. 1838, Guangzhou, 510515, Guangdong, China

    Lian Tang, Shiqi Liang, Chunlin Chen, Lan Chen, Cheng Peng & Ping Liu

  3. Department of Radiology, NanFang Hospital, Southern Medical University, Guangzhou, China

    Jie Feng

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  1. Lian Tang
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Contributions

Lian Tang contributed to data collection, analysis and interpretation, and manuscript writing. Shiqi Liang contributed to data analysis. Chunlin Chen contributed to data analysis. Jie Feng contributed to data collection and radiology Image guidance. Lan Chen contributed to data collection and analysis. Cheng Peng contributed to data collection and analysis. Ping Liu contributed to project development.

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Correspondence to Ping Liu.

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Tang, L., Liang, S., Chen, C. et al. Comparison of urethral parameters in females presenting cystoceles with and without stress urinary incontinence based on dynamic magnetic resonance imaging: are they different?. Abdom Radiol (2024). https://doi.org/10.1007/s00261-023-04175-7

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