Method and reliability of measuring midurethral area and echogenicity, and changes during and after pregnancy

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

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)
41 Downloads (Pure)

Abstract

INTRODUCTION AND HYPOTHESIS:
Internal closure of the urethral sphincter is one of the mechanisms in maintaining continence. Little is known about changes in the urethral sphincter during pregnancy. We designed this study to develop a reliable method to measure the area and mean echogenicity of the midurethra during and after pregnancy and to assess changes over time.
METHODS:
Two observers independently segmented the urethra as follows: in the sagittal plane, the urethra was positioned vertically, the marker was placed in the middle section of the lumen of the urethra, and eight tomographic US images of 2.5 -mm slices were obtained. The central image was selected, and area and mean echogenicity were calculated automatically. Intra- and interobserver reliability were determined by intraclass correlation coefficients (ICC) and their 95% confidence intervals (CI). Two hundred and eighty women underwent TPUS at 12 weeks and 36 weeks of gestation and 6 months postpartum, and 3D/4D transperineal ultrasound (TPUS) images of 40 pregnant nulliparous women were used for the reliability study. Paired t tests were used to assess changes in echogenicity and area.
RESULTS:
The ICC for measuring the area was substantial, at 0.77 and for measuring mean echogenicity was almost perfect, at 0.86. In the total study group (n = 280), midurethral area and mean echogenicity were significantly lower 6 months after delivery compared with 12 and 36 weeks of gestation.
CONCLUSIONS:
Our protocol for measuring area and mean echogenicity of the midurethra is reliable. This study indicates that structural changes in the midurethraoccur during pregnancy.
Original languageEnglish
Pages (from-to)1379-1385
Number of pages7
JournalInternational Urogynecology Journal
Volume29
Issue number9
Early online date12 Mar 2018
DOIs
Publication statusPublished - 1 Sep 2018

Keywords

  • UT-Hybrid-D

Fingerprint Dive into the research topics of 'Method and reliability of measuring midurethral area and echogenicity, and changes during and after pregnancy'. Together they form a unique fingerprint.

  • Cite this

    van de Waarsenburg, M. K., van Hoogenhuijze, N. E., Bellos-Grob, A. T. M., Schweitzer, K. J., Withagen, M. I. J., & van der Vaart , C. H. (2018). Method and reliability of measuring midurethral area and echogenicity, and changes during and after pregnancy. International Urogynecology Journal, 29(9), 1379-1385. https://doi.org/10.1007/s00192-018-3580-z