Ultrasonographic and Doppler velocimetric evaluation of the levator ani muscle in premenopausal women with and without urinary stress incontinence.
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.
Oliveira
Emerson
E
Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil. emerson.gineco@unifesp.epm.br
Castro
Rodrigo A
RA
Takano
Cláudia C
CC
Bezerra
Leonardo R P S
LR
Sartori
Marair G F
MG
Lima
Geraldo R
GR
Baracat
Edmund C
EC
Girão
Manoel J B C
MJ
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*