[Echo-dynamic study of female urinary incontinence: our experience with the use of tridimensional ultrasonography].
Traditional 2-D ultrasound is a fast, inexpensive, non-invasive procedure and may be used routinely for the pre and post-operative evaluation of patients with various grade of cystocele, but a new tool in ultrasound investigation is recently available: the 3D scan. Our aim is to assess the real usefulness of 3D scan in the evaluation of cystocele grade. 15 women with clinical and urodynamic findings of genuine stress incontinence and grade 2-3 cystocele (in accord to Baden-Walker grading) underwent both ultrasonographic 3D imaging and traditional 2D trans labial scan with Convex probe (3.5 Mh). Correct evaluation of the relationships between the bladder, urethrovesical junction, urethra and pubic bones at rest and when straining was correctly evaluated by 2D scan in all the women underwent the examination, whereas 3D scan did not let us exactly quantify the same anatomical defect. 3D ultrasound did not prove to be as useful as traditional trans-labial 2D ultrasound procedure to provide an objective demonstration of the mobility of the urethrovesical junction. A possible explanation is that the lack of reliability of 3D investigation is due to the impossibility of real-time scanning that make approximate the choice of the image to evaluate. In conclusion traditional ultrasound is up to now an important complementary evaluation for the study of female urinary incontinence which allows not only morphological documentation but can also improve our knowledge of function and anatomy of lower urinary tract. Finally it is basic to stress that a worldwide standardisation will be the starting point for the real success of this technique and, especially for the new 3D scan, it will be important to achieve this goal together a large amount of data to compare for defining the real importance of this investigation.
Fiori
Massimo
M
Unità Operativa di Urologia, Ospedale L. Pierantoni, ASL Forlì. fiorifo@tin.it
Gunelli
Roberta
R
Bercovich
Eduard
E
D005260:Female; D006801:Humans; D014463:Ultrasonography; D014549:Urinary Incontinence / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014563:Urodynamics