title: [Assessment of the angle between puborectal muscles in women with and without stress urinary incontinence in three-dimensional sonograph].
abstract: Contemporary care of the woman, especially in the postmenopausal period is based not only on gynaecological periodic inspections, but also on the routine evaluation of the pelvis minorwith the ultrasound examination. Based on this examination we can manytimes initially diversify causes of wrong manifestations, so like, e.g., urinary incontinence, of social pathologies coming into existence in the result rolling within the pelvis minor. Urinary incontinence is a complaint which is changing the quality of life. Three-dimensional sonography (3D USG) supplies us more information than traditional two-dimensional sonography. It let us to make dynamic representation of examining structures and let us to observe them in any angle we need. The best way for sonographic examination of lower pelvis minor is translabial sonography, because it doesn't change mutual relationship of any parts in lower pelvic area, just like transrectal ortransvaginal probes can make. For good treatment of symptoms of urinary incontinence we have to perform not only functional examination of lower urinary tract, but also make very accurate rate of the static of female genital organs and pelvic floor.
  
  
  BACKGROUND
  The aim of study was to rate the angle between both puborectal muscles measurements using translabial three-dimensional sonography in women with stress urinary incontinence without descension of the female genital tract.
  
  
  METHODS
  Studied group included 100 patients who were examined with GE Kretz Voluson 730 (GE, Austria) scaner equipped 6-9 MHztranslabial probe. First group with stress urinary incontinence comprised 50 women in the mean age 56.22 (+/- 10.43) years old and the second without symptoms--50 women in the mean age 49.0 (+/- 13.22) years old. All cases of urinary stress incontinence in first group was confirm with urodynamic examination. Women in both groups were in similar body mass index, means (+/-SD): 26.88 (+/- 2.02) and 26.20 (+/- 4.14), respectively. Menopausal status in both groups was not statistically significant and aggregate 7.21 (+/- 8.71) in group of women with stress urinary incontinence and 4.70 (+/- 6.32) in group of women without symptoms. Means (+/- SD) quantity of deliveries was significantly higher in group of women with stress urinary incontinence than in control group and amount to 2.40 (+/- 1.03) and 1.56 (+/- 1.34), respectively. In all cases 3D USG coronal view of pelvic diaphragm was obtained and the angle between both puborectal muscles were measured. All women had about 200 ml urine in the bladder.
  
  
  RESULTS
  Means (+/-SD) of this angle in these groups were 65.48 +/- 9.22 and 58.64 +/- 9.17 degrees, respectively. The differences between both groups in all measurements were statistically significant (p<0.0015).
  
  
  CONCLUSIONS
  Stated during translabial three-dimensional ultrasound examination considerably different values of the angle between puborectal muscles at women with and without the urinary incontinence can be more helpful in a accurate diagnosing of the type of the urinary incontinence.
authors.forename: Norbert
authors.initials: N
authors.lastname: Stachowicz
authors.forename: Sylwia
authors.initials: S
authors.lastname: Stachowicz
authors.forename: Dorota
authors.initials: D
authors.lastname: Morawska
authors.forename: Agata
authors.initials: A
authors.lastname: Smoleń
authors.forename: Jan
authors.initials: J
authors.lastname: Kotarski
mesh_terms: D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging*; D017773:Pelvic Floor / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography; D014550:Urinary Incontinence, Stress / Q000000981:diagnostic imaging*