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Vascularity of the urethra in continent women using colour doppler high-frequency endovaginal ultrasonography.

Lone F, Sultan AH, Stankiewicz A, Thakar R, Wieczorek AP - Springerplus (2014)

Bottom Line: Significant impairment of vascularity was observed in multiparous patients as compared to iparous and was reflected by increased values of RImix (p < 0.001) and PImix (p < 0.001), and decreased values of Vmix (p < 0.001), Amix (p < 0.001), Imix (p < 0.001) in axial and midsagittal sections of the midurethra.A significant decrease of mean value ± SD of Imix- from 0.02 ± 0.02 in iparous to 0.005 ± 0.01 in multiparous was observed.Compared to continent iparous women, continent multiparous women demonstrated a significant reduction in the vascularity parameters in all measured variables when parity was accounted for.

View Article: PubMed Central - PubMed

Affiliation: Subspecialty trainee Urogynaecology, Department of Obstetrics and Gynaecology, Croydon University Hospital, Croydon, UK.

ABSTRACT

Objectives: To assess the urethral vascularity in continent women using colour doppler high frequency endovaginal ultrasonography (EVUS).

Methods: We recruited 61 continent women attending gynaecology clinics between July and October 2009. Exclusion criteria included symptoms of urinary incontinence, voiding dysfunction, pelvic organ prolapse or urinary tract infection. The participants underwent EVUS using high frequency (9-12 MHz) biplane transducer (type 8848 BK Medical), according to a standardised protocol. Colour Doppler US was performed in sagittal plane and in transverse plane at the level of the mid-urethra. Ten seconds video files were recorded and following vascular parameters: flow velocity (Vmix), area of the vessels (Amix), intensity of vascularity (Imix), pulsatility index (PImix) and resistance index (RImix) was evaluated.

Results: There were 30 iparous (49.2%) women and 31 multiparous women (50.8%) with a mean (±SD) age of 32 (±4) and 46 (±6) years respectively. Significant impairment of vascularity was observed in multiparous patients as compared to iparous and was reflected by increased values of RImix (p < 0.001) and PImix (p < 0.001), and decreased values of Vmix (p < 0.001), Amix (p < 0.001), Imix (p < 0.001) in axial and midsagittal sections of the midurethra. A significant decrease of mean value ± SD of Imix- from 0.02 ± 0.02 in iparous to 0.005 ± 0.01 in multiparous was observed. Cronbach alpha, used to assess vascular correlations and parity demonstrated a reduction when expressed only for vascular parameters, indicating that number of deliveries is an important factor while assessing urethral vascularity.

Conclusions: Compared to continent iparous women, continent multiparous women demonstrated a significant reduction in the vascularity parameters in all measured variables when parity was accounted for.

Advances in knowledge: This study provides the basis for further research in assessing urethral vascularity in women.

No MeSH data available.


Related in: MedlinePlus

Endovaginal US and Pixel Flux technique in axial section of the mid urethra. a Endovaginal US with the use of high-frequency 180 degrees rotational transducer (type 8848, B-K Medical) in axial section of the mid urethra, colour Doppler mode. Arrows pointing the borders of the urethra. RS- rhabdosphincter. b Pixel Flux technique: Region of interest (ROI) in axial section of mid urethra showing the local perfusion relief.
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Fig1: Endovaginal US and Pixel Flux technique in axial section of the mid urethra. a Endovaginal US with the use of high-frequency 180 degrees rotational transducer (type 8848, B-K Medical) in axial section of the mid urethra, colour Doppler mode. Arrows pointing the borders of the urethra. RS- rhabdosphincter. b Pixel Flux technique: Region of interest (ROI) in axial section of mid urethra showing the local perfusion relief.

Mentions: The transducer was placed in the vagina in the neutral position to avoid any pressure on the surrounding structures distorting the anatomy (Santoro et al. 2009). The examination was performed at rest, with the use of colour doppler mode for the assessment of the urethral vascularity pattern, both in sagittal and axial sections of the urethra. This was recorded as video file (10 s or 3 heart cycles). Further off-line analysis with the use of Pixel Flux software was performed by two independent and experienced clinicians (AS and FL). The following vascular parameters were assessed: flow velocity (Vmix), area of the vessels (Amix), intensity of vascularity (Imix), resistance index (RImix) and pulsatility index (PImix) in a predefined region of interest (ROI) in the axial [Figure 1a, 1b] and midsagittal [Figures 2a and 2b] sections. ROI was set on the external borders of the mid-urethra, comprising the lisosphincter and rhabdosphincter muscle [Figures 1b and 2b].Figure 1


Vascularity of the urethra in continent women using colour doppler high-frequency endovaginal ultrasonography.

Lone F, Sultan AH, Stankiewicz A, Thakar R, Wieczorek AP - Springerplus (2014)

Endovaginal US and Pixel Flux technique in axial section of the mid urethra. a Endovaginal US with the use of high-frequency 180 degrees rotational transducer (type 8848, B-K Medical) in axial section of the mid urethra, colour Doppler mode. Arrows pointing the borders of the urethra. RS- rhabdosphincter. b Pixel Flux technique: Region of interest (ROI) in axial section of mid urethra showing the local perfusion relief.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4216823&req=5

Fig1: Endovaginal US and Pixel Flux technique in axial section of the mid urethra. a Endovaginal US with the use of high-frequency 180 degrees rotational transducer (type 8848, B-K Medical) in axial section of the mid urethra, colour Doppler mode. Arrows pointing the borders of the urethra. RS- rhabdosphincter. b Pixel Flux technique: Region of interest (ROI) in axial section of mid urethra showing the local perfusion relief.
Mentions: The transducer was placed in the vagina in the neutral position to avoid any pressure on the surrounding structures distorting the anatomy (Santoro et al. 2009). The examination was performed at rest, with the use of colour doppler mode for the assessment of the urethral vascularity pattern, both in sagittal and axial sections of the urethra. This was recorded as video file (10 s or 3 heart cycles). Further off-line analysis with the use of Pixel Flux software was performed by two independent and experienced clinicians (AS and FL). The following vascular parameters were assessed: flow velocity (Vmix), area of the vessels (Amix), intensity of vascularity (Imix), resistance index (RImix) and pulsatility index (PImix) in a predefined region of interest (ROI) in the axial [Figure 1a, 1b] and midsagittal [Figures 2a and 2b] sections. ROI was set on the external borders of the mid-urethra, comprising the lisosphincter and rhabdosphincter muscle [Figures 1b and 2b].Figure 1

Bottom Line: Significant impairment of vascularity was observed in multiparous patients as compared to iparous and was reflected by increased values of RImix (p < 0.001) and PImix (p < 0.001), and decreased values of Vmix (p < 0.001), Amix (p < 0.001), Imix (p < 0.001) in axial and midsagittal sections of the midurethra.A significant decrease of mean value ± SD of Imix- from 0.02 ± 0.02 in iparous to 0.005 ± 0.01 in multiparous was observed.Compared to continent iparous women, continent multiparous women demonstrated a significant reduction in the vascularity parameters in all measured variables when parity was accounted for.

View Article: PubMed Central - PubMed

Affiliation: Subspecialty trainee Urogynaecology, Department of Obstetrics and Gynaecology, Croydon University Hospital, Croydon, UK.

ABSTRACT

Objectives: To assess the urethral vascularity in continent women using colour doppler high frequency endovaginal ultrasonography (EVUS).

Methods: We recruited 61 continent women attending gynaecology clinics between July and October 2009. Exclusion criteria included symptoms of urinary incontinence, voiding dysfunction, pelvic organ prolapse or urinary tract infection. The participants underwent EVUS using high frequency (9-12 MHz) biplane transducer (type 8848 BK Medical), according to a standardised protocol. Colour Doppler US was performed in sagittal plane and in transverse plane at the level of the mid-urethra. Ten seconds video files were recorded and following vascular parameters: flow velocity (Vmix), area of the vessels (Amix), intensity of vascularity (Imix), pulsatility index (PImix) and resistance index (RImix) was evaluated.

Results: There were 30 iparous (49.2%) women and 31 multiparous women (50.8%) with a mean (±SD) age of 32 (±4) and 46 (±6) years respectively. Significant impairment of vascularity was observed in multiparous patients as compared to iparous and was reflected by increased values of RImix (p < 0.001) and PImix (p < 0.001), and decreased values of Vmix (p < 0.001), Amix (p < 0.001), Imix (p < 0.001) in axial and midsagittal sections of the midurethra. A significant decrease of mean value ± SD of Imix- from 0.02 ± 0.02 in iparous to 0.005 ± 0.01 in multiparous was observed. Cronbach alpha, used to assess vascular correlations and parity demonstrated a reduction when expressed only for vascular parameters, indicating that number of deliveries is an important factor while assessing urethral vascularity.

Conclusions: Compared to continent iparous women, continent multiparous women demonstrated a significant reduction in the vascularity parameters in all measured variables when parity was accounted for.

Advances in knowledge: This study provides the basis for further research in assessing urethral vascularity in women.

No MeSH data available.


Related in: MedlinePlus