Ultrazvukové parametry dolníhomočového traktu u kontinentních žen před a po menopauze

Ultrasonic Parameters of theLower Urinary Tract in Continent Women before and after theMenopause

Objective:
The aims of our study were to analyze ultrasound parameters of the lower urinary tractin continent women before and after menopause.Design: Prospective clinical study.Setting: Department of Obstetrics and Gynecology, Charles University, Prague, Czech RepublicMethods: Seventy continent premenopausal women (Group 1) and thirty women after menopause (Group 2) participated in the study. In the group 1 - mean age was 32.8 years, mean weight was64.2 kg and mean parity was 0,8. In the group 2 - mean age was 53.2 years mean weight was 73.4kg, and mean parity 1.61. A perineal and introital ultrasound examination was performed inwomen in a supine position (Acuson 128 XP - 10) with the bladder filled at a mean capacity 283ccm. Funneling was described as an enlarger distance between the inner edges of proximalurethra during Valsalva. The descent of the cervix of uterus was calculated as a difference comprising the distances between the cervix of the uterus and the surface of ultrasound probe at restand during Valsalva.Results: We found significant differences in bladder neck position and mobility between this twogroups. We did not find funneling during Valsalva in both groups. On the contrary, in the “hypermobile” group (in the patients with differences between the
angle during Valsalva and the
angle during squeezing > 60°) the distance between the inner edges of internal orifice is signifi-cantly (p = 0.0038) smaller than in women with UVJ relatively less mobile. Conclusion: In continent women after menopause we find larger mobility of UVJ, but withoutfunneling of the urethra. In women with hypermobility of UVJ leakage does not occur, due to theproven increased closure of internal orifice during Valsalva.

Key words:
female urinary incontinence, ultrasonography, menopausa