Mean echogenicity and area of puborectalis muscle in women with stress urinary incontinence during pregnancy and after delivery

M.K. van de Waarsenburg (Corresponding Author), M.I.J. Withagen, Anique Theodora Maria Bellos-Grob, K.J. Schweitzer, G.A. van Veelen, C. H. van der Vaart

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Abstract

INTRODUCTION AND HYPOTHESIS:
Pregnancy and childbirth are risk factors for the development of stress urinary incontinence (SUI). Urinary continence depends on normal urethral support, which is provided by normal levator ani muscle function. Our objective was to compare mean echogenicity and the area of the puborectalis muscle between women with and those without SUI during and after their first pregnancy.
METHODS:
We examined 280 nulliparous women at a gestational age of 12 weeks, 36 weeks, and 6 months after delivery. They filled out the validated Urogenital Distress Inventory and underwent perineal ultrasounds. SUI was considered present if the woman answered positively to the question "do you experience urine leakage related to physical activity, coughing, or sneezing?" Mean echogenicity of the puborectalis muscle (MEP) and puborectalis muscle area (PMA) were calculated. The MEP and PMA during pregnancy and after delivery in women with and without SUI were compared using independent Student's t test.
RESULTS:
After delivery the MEP was higher in women with SUI if the pelvic floor was at rest or in contraction, with effect sizes of 0.30 and 0.31 respectively. No difference was found in the area of the puborectalis muscle between women with and those without SUI.
CONCLUSIONS:
Women with SUI after delivery had a statistically significant higher mean echogenicity of the puborectalis muscle compared with non-SUI women when the pelvic floor was at rest and in contraction; the effect sizes were small. This higher MEP is indicative of a relatively higher intramuscular extracellular matrix component and could represent diminished contractile function.
Original languageEnglish
Pages (from-to)1723-1728
Number of pages6
JournalInternational Urogynecology Journal and Pelvic Floor Dysfunction
Volume27
Issue number11
DOIs
Publication statusPublished - 1 Nov 2016

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Stress Urinary Incontinence
Pregnancy
Muscles
Pelvic Floor
Sneezing
Urinary Incontinence
Anal Canal
Gestational Age
Extracellular Matrix
Urine
Parturition
Exercise
Students
Equipment and Supplies

Keywords

  • UT-Hybrid-D

Cite this

van de Waarsenburg, M.K. ; Withagen, M.I.J. ; Bellos-Grob, Anique Theodora Maria ; Schweitzer, K.J. ; van Veelen, G.A. ; van der Vaart , C. H. . / Mean echogenicity and area of puborectalis muscle in women with stress urinary incontinence during pregnancy and after delivery. In: International Urogynecology Journal and Pelvic Floor Dysfunction. 2016 ; Vol. 27, No. 11. pp. 1723-1728.
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abstract = "INTRODUCTION AND HYPOTHESIS: Pregnancy and childbirth are risk factors for the development of stress urinary incontinence (SUI). Urinary continence depends on normal urethral support, which is provided by normal levator ani muscle function. Our objective was to compare mean echogenicity and the area of the puborectalis muscle between women with and those without SUI during and after their first pregnancy.METHODS: We examined 280 nulliparous women at a gestational age of 12 weeks, 36 weeks, and 6 months after delivery. They filled out the validated Urogenital Distress Inventory and underwent perineal ultrasounds. SUI was considered present if the woman answered positively to the question {"}do you experience urine leakage related to physical activity, coughing, or sneezing?{"} Mean echogenicity of the puborectalis muscle (MEP) and puborectalis muscle area (PMA) were calculated. The MEP and PMA during pregnancy and after delivery in women with and without SUI were compared using independent Student's t test.RESULTS: After delivery the MEP was higher in women with SUI if the pelvic floor was at rest or in contraction, with effect sizes of 0.30 and 0.31 respectively. No difference was found in the area of the puborectalis muscle between women with and those without SUI.CONCLUSIONS: Women with SUI after delivery had a statistically significant higher mean echogenicity of the puborectalis muscle compared with non-SUI women when the pelvic floor was at rest and in contraction; the effect sizes were small. This higher MEP is indicative of a relatively higher intramuscular extracellular matrix component and could represent diminished contractile function.",
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Mean echogenicity and area of puborectalis muscle in women with stress urinary incontinence during pregnancy and after delivery. / van de Waarsenburg, M.K. (Corresponding Author); Withagen, M.I.J.; Bellos-Grob, Anique Theodora Maria; Schweitzer, K.J.; van Veelen, G.A.; van der Vaart , C. H. .

In: International Urogynecology Journal and Pelvic Floor Dysfunction, Vol. 27, No. 11, 01.11.2016, p. 1723-1728.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Mean echogenicity and area of puborectalis muscle in women with stress urinary incontinence during pregnancy and after delivery

AU - van de Waarsenburg, M.K.

AU - Withagen, M.I.J.

AU - Bellos-Grob, Anique Theodora Maria

AU - Schweitzer, K.J.

AU - van Veelen, G.A.

AU - van der Vaart , C. H.

N1 - Springer deal

PY - 2016/11/1

Y1 - 2016/11/1

N2 - INTRODUCTION AND HYPOTHESIS: Pregnancy and childbirth are risk factors for the development of stress urinary incontinence (SUI). Urinary continence depends on normal urethral support, which is provided by normal levator ani muscle function. Our objective was to compare mean echogenicity and the area of the puborectalis muscle between women with and those without SUI during and after their first pregnancy.METHODS: We examined 280 nulliparous women at a gestational age of 12 weeks, 36 weeks, and 6 months after delivery. They filled out the validated Urogenital Distress Inventory and underwent perineal ultrasounds. SUI was considered present if the woman answered positively to the question "do you experience urine leakage related to physical activity, coughing, or sneezing?" Mean echogenicity of the puborectalis muscle (MEP) and puborectalis muscle area (PMA) were calculated. The MEP and PMA during pregnancy and after delivery in women with and without SUI were compared using independent Student's t test.RESULTS: After delivery the MEP was higher in women with SUI if the pelvic floor was at rest or in contraction, with effect sizes of 0.30 and 0.31 respectively. No difference was found in the area of the puborectalis muscle between women with and those without SUI.CONCLUSIONS: Women with SUI after delivery had a statistically significant higher mean echogenicity of the puborectalis muscle compared with non-SUI women when the pelvic floor was at rest and in contraction; the effect sizes were small. This higher MEP is indicative of a relatively higher intramuscular extracellular matrix component and could represent diminished contractile function.

AB - INTRODUCTION AND HYPOTHESIS: Pregnancy and childbirth are risk factors for the development of stress urinary incontinence (SUI). Urinary continence depends on normal urethral support, which is provided by normal levator ani muscle function. Our objective was to compare mean echogenicity and the area of the puborectalis muscle between women with and those without SUI during and after their first pregnancy.METHODS: We examined 280 nulliparous women at a gestational age of 12 weeks, 36 weeks, and 6 months after delivery. They filled out the validated Urogenital Distress Inventory and underwent perineal ultrasounds. SUI was considered present if the woman answered positively to the question "do you experience urine leakage related to physical activity, coughing, or sneezing?" Mean echogenicity of the puborectalis muscle (MEP) and puborectalis muscle area (PMA) were calculated. The MEP and PMA during pregnancy and after delivery in women with and without SUI were compared using independent Student's t test.RESULTS: After delivery the MEP was higher in women with SUI if the pelvic floor was at rest or in contraction, with effect sizes of 0.30 and 0.31 respectively. No difference was found in the area of the puborectalis muscle between women with and those without SUI.CONCLUSIONS: Women with SUI after delivery had a statistically significant higher mean echogenicity of the puborectalis muscle compared with non-SUI women when the pelvic floor was at rest and in contraction; the effect sizes were small. This higher MEP is indicative of a relatively higher intramuscular extracellular matrix component and could represent diminished contractile function.

KW - UT-Hybrid-D

U2 - 10.1007/s00192-016-3030-8

DO - 10.1007/s00192-016-3030-8

M3 - Article

VL - 27

SP - 1723

EP - 1728

JO - International Urogynecology Journal

JF - International Urogynecology Journal

SN - 0937-3462

IS - 11

ER -