title: High-resolution endovaginal MR imaging in stress urinary incontinence.
abstract: The causes of stress urinary incontinence are not completely known. Recent papers have stressed the importance of more anatomical information, which may help to elucidate the mechanism of stress urinary incontinence. The purpose of this study was to evaluate the prevalence of lesions of the urethral support mechanism and lesions (defects and scars, thinning) of levator ani muscle with endovaginal MRI in a case-control study. Forty women (median age 52 years, age range 40-65 years)--20 patients with stress urinary incontinence (cases) and 20 age-matched healthy volunteers (controls)--underwent endovaginal MRI: axial, coronal, and sagittal T2-weighted turbo spin echo. The examinations were evaluated for the presence of lesions of urethral supporting structures and levator ani and scar tissue of the levator ani. The thickness of the levator ani muscle was measured. Lesions of the urethral support system and levator ani were significantly more prevalent in cases than in controls ( p<0.01). Median levator ani thickness in patients was significantly lower than in healthy controls [2.5 mm (range 0.9-4.1 mm) vs 3.9 mm (range 1.4-7 mm)] ( p<0.01). This study indicates a relationship between stress urine incontinence and the presence of lesions of the urethral support and levator ani and levator ani thinning.
authors.affiliation: Department of Radiology, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands. j.stoker@amc.uva.nl
authors.forename: Jaap
authors.initials: J
authors.lastname: Stoker
authors.forename: Elena
authors.initials: E
authors.lastname: Rociu
authors.forename: J L H Ruud
authors.initials: JL
authors.lastname: Bosch
authors.forename: Embert J
authors.initials: EJ
authors.lastname: Messelink
authors.forename: Victor P M
authors.initials: VP
authors.lastname: van der Hulst
authors.forename: Annette G
authors.initials: AG
authors.lastname: Groenendijk
authors.forename: Marinus J C
authors.initials: MJ
authors.lastname: Eijkemans
authors.forename: Johan S
authors.initials: JS
authors.lastname: Laméris
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology; D017773:Pelvic Floor; D014521:Urethra / Q000473:pathology; D014550:Urinary Incontinence, Stress / Q000175:diagnosis*