E-Posters-Dynamic Anterior Compartment Ultrasound Can Evaluate Urethral Shape and Function During Squeeze and Valsalva Maneuvers

Dynamic Anterior Compartment Ultrasound Can Evaluate Urethral Shape and Function During Squeeze and Valsalva Maneuvers - Ghazaleh Rostami Nia, MD, MSc

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The study aimed to use dynamic ultrasound to examine and quantify the changes in urethral shape caused by voluntary levator squeeze and Valsalva maneuvers. The study included women who presented for urodynamic testing and underwent endovaginal dynamic pelvic floor ultrasound. Patients performed squeeze and Valsalva maneuvers while imaging was taken. Patients with stress urinary incontinence or certain findings on the POP-Q were excluded from the analysis. Urethral motion relative to the symphysis pubis and shape changes were measured, including length, angle, and thickness. Comparisons were made between rest and squeeze, and rest and maximum Valsalva.<br /><br />Results from 16 subjects showed that voluntary contraction of levators and striated urethral muscle complexes reduced the thickness of the urethra, particularly in the distal urethra. Lifting of the bladder neck during squeeze increased urethral length, especially in the retropubic region. During Valsalva, the urethra shortened and there was a larger rotational movement of the proximal urethra anteriorly around the pubic bone, while the distal urethra moved inferiorly, creating a "urethral knee" appearance.<br /><br />The study highlights that dynamic anterior compartment ultrasound is a useful tool for assessing urethral closure structure and function. Future studies are warranted to determine the relationship between these observations and continence.<br /><br />In summary, this study demonstrated the ability of dynamic ultrasound to assess urethral shape changes during pelvic floor maneuvers. The findings provide valuable insights into the structural and functional aspects of urethral closure.

Keywords

dynamic ultrasound

urethral shape

levator squeeze

Valsalva maneuvers

urodynamic testing

stress urinary incontinence

urethral motion

bladder neck lifting

retropubic region

urethral closure