Reliability of real-time ultrasound to detect pelvic floor muscle contraction in urinary incontinent women.
OBJECTIVE
We determined the reliability of real-time ultrasound for detecting involuntary or reflex pelvic floor muscle contraction.


METHODS
A total of 118 women with the symptomatic and urodynamic evidence of stress urinary incontinence were recruited in a 3-year period from tertiary referral urogynecology clinics. Under the oral instruction of strong coughing involuntary pelvic floor muscle contraction was detected using introital ultrasound in real-time and cine loop modes. Two dynamic imaging features were considered involuntary pelvic floor muscle contraction, including an inward clitoral motion and a superior-anterior anorectal lift before or during coughing.


RESULTS
Real-time ultrasound had good reliability to detect involuntary pelvic floor muscle contraction. For interobserver and intra-observer reliability Cohen's kappa was 0.645 to 0.679. Of the 118 women real-time ultrasound before or during coughing showed an inward clitoral motion in 100 (93%) and an anorectal lift in 108 (92%). Neither type of contraction during coughing was identified in 2 women. Although the 2 contraction patterns were synchronized in 88% of women, for this synchronization kappa was only 0.159, indicating poor coordination between these 2 involuntary activities.


CONCLUSIONS
Real-time ultrasound is a reliable tool for detecting involuntary pelvic floor muscle contraction.
Division of Urogynecology, Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, Republic of China.
Jenn-Ming
JM
Yang
Shwu-Huey
SH
Yang
Shu-Yu
SY
Yang
Evelyn
E
Yang
Wen-Chen
WC
Huang
D000328:Adult; D000368:Aged; D003199:Computer Systems; D005260:Female; D006801:Humans; D008875:Middle Aged; D009119:Muscle Contraction; D017773:Pelvic Floor / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D015203:Reproducibility of Results; D013997:Time Factors; D014463:Ultrasonography; D014550:Urinary Incontinence, Stress / Q000000981:diagnostic imaging* / Q000503:physiopathology*