Vascularity of the urethra in continent women using colour doppler high-frequency endovaginal ultrasonography.
OBJECTIVE
To assess the urethral vascularity in continent women using colour doppler high frequency endovaginal ultrasonography (EVUS).


METHODS
We recruited 61 continent women attending gynaecology clinics between July and October 2009. Exclusion criteria included symptoms of urinary incontinence, voiding dysfunction, pelvic organ prolapse or urinary tract infection. The participants underwent EVUS using high frequency (9-12 MHz) biplane transducer (type 8848 BK Medical), according to a standardised protocol. Colour Doppler US was performed in sagittal plane and in transverse plane at the level of the mid-urethra. Ten seconds video files were recorded and following vascular parameters: flow velocity (Vmix), area of the vessels (Amix), intensity of vascularity (Imix), pulsatility index (PImix) and resistance index (RImix) was evaluated.


RESULTS
There were 30 nulliparous (49.2%) women and 31 multiparous women (50.8%) with a mean (±SD) age of 32 (±4) and 46 (±6) years respectively. Significant impairment of vascularity was observed in multiparous patients as compared to nulliparous and was reflected by increased values of RImix (p < 0.001) and PImix (p < 0.001), and decreased values of Vmix (p < 0.001), Amix (p < 0.001), Imix (p < 0.001) in axial and midsagittal sections of the midurethra. A significant decrease of mean value ± SD of Imix- from 0.02 ± 0.02 in nulliparous to 0.005 ± 0.01 in multiparous was observed. Cronbach alpha, used to assess vascular correlations and parity demonstrated a reduction when expressed only for vascular parameters, indicating that number of deliveries is an important factor while assessing urethral vascularity.


CONCLUSIONS
Compared to continent nulliparous women, continent multiparous women demonstrated a significant reduction in the vascularity parameters in all measured variables when parity was accounted for.


CONCLUSIONS
This study provides the basis for further research in assessing urethral vascularity in women.
Subspecialty trainee Urogynaecology, Department of Obstetrics and Gynaecology, Croydon University Hospital, Croydon, UK.
Farah
F
Lone
Department of Obstetrics and Gynaecology, Croydon University Hospital, Croydon, UK.
Abdul H
AH
Sultan
Clinical Research Fellow, Department of Obstetrics and Gynaecology, Croydon University Hospital, Croydon, UK.
Aleksandra
A
Stankiewicz
Consultant Obstetrician and Urogynaecologist, Department of Obstetrics and Gynaecology, Croydon University Hospital, Croydon, UK.
Ranee
R
Thakar
Consultant Radiologist, Department of Diagnostic Imaging, Children's Teaching Hospital, Lublin Medical University, Lublin, Poland.
Andrzej Pawel
AP
Wieczorek
Colour doppler; Endovaginal ultrasound; Pixel flux; Urethra; Urinary incontinence; Vascularity