title: Assessment of urethral vascularity using 2D colour Doppler high-frequency endovaginal ultrasonography in women treated for symptomatic stress urinary incontinence: 1-year prospective follow-up study.
abstract: BACKGROUND
  Urethral vascularity is responsible for organ perfusion. It is also believed to contribute to maintaining the normal tension in the urethral mucosa and contributes to approximately one third of urethral closure pressure. We hypothesised that in women undergoing treatment for stress urinary incontinence (SUI), there is no change in blood flow intensity.
  
  
  METHODS
  In this pilot study we recruited women attending the urogynaecology clinics between July and October 2009. Exclusion criteria included symptoms of pelvic organ prolapse or urinary tract infection. Colour Doppler ultrasound was performed at the level of the mid-urethra using a high-frequency (9-12 MHz) endovaginal ultrasonography (EVUS) focusing on the following vascular parameters: flow velocity (V), area of the vessels (A), intensity of perfusion (I), Tissue Pulsatility Index (TPI) and Tissue Resistance Index (TRI). Vascular assessments were repeated at 1 year.
  
  
  RESULTS
  We examined 67 women with symptoms of SUI (17 women had surgery and 50 conservative management, i.e., pelvic floor muscle exercises). The mean (± SD) age in the conservative and surgical groups was 46 (±11) and 40 (±9) years respectively and median (range) parity was 2 (0-8) in both groups. Compared to baseline, no statistically significant differences were observed within each group (p > 0.05) or between the values of vascular parameters (V, A, I, TRI and TPI) at 1 year. There was also no difference in vascular parameters between the two groups.
  
  
  CONCLUSIONS
  At 12 months there is no change in vascularity parameters in women who opt for conservative or surgical treatment of SUI.
authors.affiliation: Department of Obstetrics and Gynecology, Croydon University Hospital, 530 London Road, Croydon, UK, CR7 7YE.
authors.forename: Farah
authors.initials: F
authors.lastname: Lone
authors.affiliation: Department of Obstetrics and Gynecology, Croydon University Hospital, 530 London Road, Croydon, UK, CR7 7YE. ranee.thakar@croydonhealth.nhs.uk.
authors.forename: Ranee
authors.initials: R
authors.lastname: Thakar
authors.affiliation: Department of Pediatric Radiology, Children's Teaching Hospital, Lublin Medical University, Lublin, Poland.
authors.forename: Andrzej P
authors.initials: AP
authors.lastname: Wieczorek
authors.affiliation: Department of Obstetrics and Gynecology, Croydon University Hospital, 530 London Road, Croydon, UK, CR7 7YE.
authors.forename: Abdul H
authors.initials: AH
authors.lastname: Sultan
authors.affiliation: Department of Obstetrics and Gynecology, Croydon University Hospital, 530 London Road, Croydon, UK, CR7 7YE.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Stankiewicz
mesh_terms: D000328:Adult; D019160:Endosonography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D013997:Time Factors; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D014521:Urethra / Q000098:blood supply* / Q000000981:diagnostic imaging*; D014550:Urinary Incontinence, Stress / Q000000981:diagnostic imaging* / Q000628:therapy; D014621:Vagina
keywords: Color Doppler; Endovaginal ultrasonography; Pixel Flux; Stress urinary incontinence; Urethral vascularity