title: Association of urinary and anal incontinence with measures of pelvic floor muscle contractility.
abstract: OBJECTIVE
  To assess the association between clinical and sonographic measures of pelvic floor muscle (PFM) function and symptoms of urinary and anal incontinence (AI).
  
  
  METHODS
  This was a retrospective study of women seen at a tertiary urogynecological unit. All women had undergone a standardized interview, clinical examination including Modified Oxford Scale (MOS) grading, urodynamic testing and four-dimensional translabial ultrasound (TLUS). Cranioventral shift of the bladder neck (BN) and reduction in the hiatal anteroposterior (AP) diameter were measured using ultrasound volumes acquired on maximal PFM contraction, blinded against all clinical data.
  
  
  RESULTS
  Data from 726 women with a mean age of 56 ± 13.7 (range, 18-88) years and a mean body mass index of 29 ± 6.1 (range, 17-55) kg/m(2) were analyzed. Stress (SI) and urge (UI) urinary incontinence were reported by 73% and 72%, respectively, and 13% had AI. Mean MOS grade was 2.4 ± 1.1 (range, 0-5). Mean cranioventral BN shift on TLUS was 7.1 ± 4.4 (range, 0.3-25.3) mm; mean reduction in AP hiatal diameter was 8.6 ± 4.8 (range, 0.3-31.3) mm. On univariate analysis, neither MOS nor TLUS measures were strongly associated with symptoms of urinary incontinence or AI; associations were non-significant except for BN displacement/SI (7.3 mm vs 6.5 mm; P = 0.028), BN displacement/UI (6.85 vs 7.75; P = 0.019), hiatal AP diameter/AI (9.6 mm vs 8.5 mm; P = 0.047) and MOS/SI (2.42 vs 2.19; P = 0.013).
  
  
  CONCLUSIONS
  In this large retrospective study we did not find any strong associations between sonographic or palpatory measures of PFM function and symptoms of urinary incontinence or AI. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
authors.affiliation: Department of Gynecology, Oslo University Hospital - Ullevål, Oslo, Norway.|Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: S H
authors.initials: SH
authors.lastname: Oversand
authors.affiliation: Sydney Medical School Nepean, University of Sydney, Penrith, Australia.|University of Kebangsaan, Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: I K
authors.initials: IK
authors.lastname: Atan
authors.affiliation: Sydney Medical School Nepean, University of Sydney, Penrith, Australia.|University of Western Sydney, Liverpool Clinical School, Sydney, Australia.
authors.forename: K L
authors.initials: KL
authors.lastname: Shek
authors.affiliation: Sydney Medical School Nepean, University of Sydney, Penrith, Australia.
authors.forename: H P
authors.initials: HP
authors.lastname: Dietz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005242:Fecal Incontinence / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010173:Palpation; D017773:Pelvic Floor / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012189:Retrospective Studies; D014463:Ultrasonography / Q000379:methods*; D014549:Urinary Incontinence / Q000453:epidemiology*; D055815:Young Adult
keywords: 3D/4D ultrasound; anal incontinence; pelvic floor; translabial ultrasound; urinary incontinence