Dynamic magnetic resonance imaging of the behavior of the mid-urethra in healthy and stress incontinent women.
OBJECTIVE
Support of the mid-urethra is thought to be an essential element of urinary continence in the female. Our aim was to image the behavior of the mid-urethra in healthy volunteers and in stress urinary incontinence (SUI) patients by dynamic magnetic resonance imaging (MRI).


METHODS
Prospective study.


METHODS
Gynecology outpatient clinic association with Department of Radiology in University Hospital of Kuopio, Finland.


METHODS
Fifteen healthy volunteers and 40 SUI women underwent dynamic MRI at rest, during pelvic floor muscle contraction, coughing and voiding with a bladder volume of 200 ml. Our aim was to determine the precise location and movement of the mid-urethra during these activities.


METHODS
The co-ordinate location and movement of the mid-urethra.


RESULTS
Continent volunteers can elevate their mid-urethra significantly higher than incontinent women. Moreover, the mid-urethra of incontinent women rotated significantly more dorsocaudally during straining and coughing than in continent women.


CONCLUSIONS
Elevation of the mid-urethra was more marked in continent compared to urinary incontinent women on pelvic floor muscle contraction suggesting sufficient support of the urethra. Downward movement of the mid-urethra was more significant in stress incontinent women than in continent volunteers.
Rinne
Kirsi Marja
KM
Department of Obstetrics and Gynecology, Kuopio University Hospital, Kuopio, Finland . kirsi.rinne@kuh.fi
Kainulainen
Sakari
S
Aukee
Sinikka
S
Heinonen
Seppo
S
Nilsson
Carl Gustaf
CG
D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D005387:Finland; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D014521:Urethra / Q000502:physiology / Q000503:physiopathology*; D014550:Urinary Incontinence, Stress / Q000503:physiopathology*