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MR defecography in assessing stress urinary incontinence with or without symptomatic pelvic organ prolapse

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Abstract

Purpose

Utilize magnetic resonance defecography (MRD) to analyze the primary pelvic floor dysfunctions in patients with stress urinary incontinence (SUI) associated with pelvic organ prolapse (POP), and in SUI patients with asymptomatic POP.

Method

We performed MRD in both SUI and POP subjects. As a primary analysis, the functional MR parameters were compared between the isolated POP and POP combined SUI groups. As a secondary analysis, the functional MR data were compared between the POP combined SUI and the SUI with asymptomatic POP (isolated SUI) groups.

Results

MRD noted the main characteristics of SUI combined moderate or severe POP, including the shorter closed urethra length (1.87 cm vs. 2.50 cm, p < 0.001), more prevalent urethral hypermobility (112.31° vs. 85.67°, p = 0.003), bladder neck funneling (48.28% vs. 20.51%, p = 0.020), lower position of vesicourethral junction (2.11 cm vs. 1.67 cm, p = 0.030), and more severe prolapse of the posterior bladder wall (6.26 cm vs. 4.35 cm, p = 0.008). The isolated SUI patients showed the shortest length of the closed urethra (1.56 cm vs. 1.87 cm, p = 0.029), a larger vesicourethral angle (153.80° vs. 107.58°, p < 0.001), the more positive bladder funneling (84.85% vs. 48.28%, p = 0.002) and a special urethral opening sign (45.45% vs. 3.45%, p < 0.001).

Conclusions

Patients with SUI accompanying POP primarily exhibit excessive urethral mobility and a shortened urethral closure. SUI patients with asymptomatic POP mainly show dysfunction of the urethra and bladder neck, characterized by the opening of the urethra and bladder neck and a shortened urethral closure.

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Data availability

The data that support the findings of this study are available on request from the corresponding author, [Min Li], upon reasonable request.

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Funding

The study was supported by Beijing Municipal Administration of Hospitals Incubating Program, PX 2020015. Author Min Li was supported by the grant.

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Author notes

  1. Min Li and Sumei Wang are the senior authors of this study and share co-corresponding authorship.

Authors and Affiliations

  1. Department of Radiology, Beijing Chao Yang Hospital, Capital Medical University, 8 Workers Stadium South Road, Chaoyang District, Beijing, 10020, China

    Min Li & Tongtong Liu

  2. Department of Urology, Beijing Chao Yang Hospital, Capital Medical University, 8 Workers Stadium South Road, Chaoyang District, Beijing, 10020, China

    Biao Wang & Peng Qiao

  3. Department of Gynecology, Beijing Chao Yang Hospital, Capital Medical University, 8 Workers Stadium South Road, Chaoyang District, Beijing, 10020, China

    Sumei Wang

Authors
  1. Min Li
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  2. Tongtong Liu
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  3. Biao Wang
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  4. Peng Qiao
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  5. Sumei Wang
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Contributions

Min Li: Design and conception; analysis and interpretation of data; drafting the article; revising the paper. Sumei Wang: POP patients inclusion; interpretation of clinical data for the work; revision of the paper. Biao Wang: SUI patients inclusion: interpretation of clinical data for the work. Tongtong Liu: Acquisition and analysis of MR imaging data for the work. Peng Qiao: Acquisition and analysis of clinical data for the work.

Corresponding authors

Correspondence to Min Li or Sumei Wang.

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Conflict of interest

This study was a research article. All authors have read and approved to the submission of “World Journal of Urology” for publication. The authors have no conflicts of interest to declare.

Ethics approval

Research involving human participants. The study protocol was approved by the Ethics Committee of the Beijing Chao Yang Hospital, Capital Medical University. Study-Special written consents were obtained from all the subjects.

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Li, M., Liu, T., Wang, B. et al. MR defecography in assessing stress urinary incontinence with or without symptomatic pelvic organ prolapse. World J Urol 42, 321 (2024). https://doi.org/10.1007/s00345-024-05014-0

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  • DOI: https://doi.org/10.1007/s00345-024-05014-0

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