An Ultrasonic Investigation of Stability of Pelvic Floor in Women with and without Urinary Stress Incontinence

Document Type : Original Article

Authors

1 Assistant Professor of Physiotherapy, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Associate Professor of Biomechanics, Faculty of Mechanical Engineering, Sharif University of Technology, Tehran, Iran.

3 Associate Professor of Obstetrics and Gynecology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

4 Professor of Biostatistics, Faculty of Medicine, Tarbiat Modares University, Tehran, Iran.

Abstract

Introduction: Bladder base movement (BBM) reflects the level of pelvic floor (PF) stability and responds with mechanical load induced changes of PF or body position. Adoption of proper body position during pelvic floor muscle (PFM) training for management of Stress Urinary Incontinence (SUI) is very important. This study was performed aimed on investigating BBM while performing different postural interventions in women with and without SUI using Trans Abdominal Ultrasonography (TAUS).
Methods: This clinical trial was conducted on 41 women referred to Vali Asr hospital of Imam Khomeini Hospital in Tehran during 2008-2009. After collecting demographic information, Trans Abdominal Ultrasonography was done at rest, during Crook lying and Straight Leg Raising (SLR), cough and Valsalva maneuvers, during PFM and Transversus Abdominis (TrA) contractions and BBM was assessed. Data were analyzed using SPSS software (version 16), Kolmogorov-Smirnov test, independent T-test, repeated measures ANOVA test, Bonferroni post hoc test and Pearson’s correlation test. P less than 0.05 was considered statistically significant.
Results: Regarding ultrasonic assessment, only the main effect of intervention was significant (p=0.0001). Adopting crook lying position affected BBM more positively in continent women compared with incontinent women (mean 6.3 vs. 2.5 mm; P<0.05). There were no differences in effects of cough, Valsalva maneuvers, TrA and PFM contractions on BBM between two groups (P>0.05).
Conclusion: Changing patient position from straight leg raising to crook lying causes upward movement of bladder base. Comparing the two groups was shown that the effect of crook lying on elevation of bladder base in control group was significantly more than patients.

Keywords

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