title: Ultrasonographic and Doppler velocimetric evaluation of the levator ani muscle in premenopausal women with and without urinary stress incontinence.
abstract: OBJECTIVE
  The objective was to evaluate the cross-sectional area (CSA) and the Doppler velocimetric parameters of the levator ani muscle vessels in premenopausal women with and without urinary stress incontinence.
  
  
  METHODS
  Sixty-three premenopausal women constituted three groups: GI (nulliparous), GII (continent multiparous), and GIII (incontinent multiparous). The patients had undergone transperineal ultrasound in which the CSA was measured and Doppler velocimetry was performed. The examination was repeated by a second observer using the same procedure.
  
  
  RESULTS
  There was a statistically significant correlation between the measurements of the observers I and II regarding all the parameters studied, except for the A/B ratio in GIII. The CSA was significantly greater in GI and GII than in GIII. As far as Doppler velocimetry is concerned there were no differences in the Doppler velocimetric indices among the three groups. Concerning the absent end diastolic shift, it was observed that there was a significantly greater incidence of such findings in GI+GII (continent women) towards GIII (incontinent women).
  
  
  CONCLUSIONS
  The CSA evaluation and the Doppler velocimetry of the levator ani muscle vessels were highly reproducible. The CSA was higher in continent women and the frequency of the absent end diastolic shift was higher in incontinent women.
authors.affiliation: Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil. emerson.gineco@unifesp.epm.br
authors.forename: Emerson
authors.initials: E
authors.lastname: Oliveira
authors.forename: Rodrigo A
authors.initials: RA
authors.lastname: Castro
authors.forename: Cláudia C
authors.initials: CC
authors.lastname: Takano
authors.forename: Leonardo R P S
authors.initials: LR
authors.lastname: Bezerra
authors.forename: Marair G F
authors.initials: MG
authors.lastname: Sartori
authors.forename: Geraldo R
authors.initials: GR
authors.lastname: Lima
authors.forename: Edmund C
authors.initials: EC
authors.lastname: Baracat
authors.forename: Manoel J B C
authors.initials: MJ
authors.lastname: Girão
mesh_terms: D000293:Adolescent; D000328:Adult; D001003:Anal Canal / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001808:Blood Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology; D004301:Doppler Effect; D005260:Female; D006801:Humans; D008875:Middle Aged; D009119:Muscle Contraction; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017697:Premenopause; D012212:Rheology / Q000379:methods; D014463:Ultrasonography; D014550:Urinary Incontinence, Stress / Q000209:etiology*