Stress Urinary Incontinence in Women
Conditions
Keywords
Stress Urinary Incontinence, Postmenopause, Ultrasonography, Postvoid Residual Urine, Lower Extremity
Brief summary
Stress urinary incontinence (SUI) in postmenopausal women is traditionally considered a local pelvic floor disorder, but emerging evidence suggests that spinopelvic and lower limb alignment may also contribute to continence mechanisms. Transperineal ultrasound α/β angles and post void residual (PVR) volume are promising imaging markers that might capture this broader biomechanical phenotype. Objective To compare hip ultrasound α/β angles, PVR volume, and lower limb and spinopelvic alignment between symptomatic and asymptomatic postmenopausal women, and to explore within group correlations between PVR and musculoskeletal alignment variables.
Detailed description
We conducted an observational case-control study with coordinated cross sectional analyses of two anonymised datasets from a tertiary urogynecology outpatient clinic in Saudi Arabia. Postmenopausal women (≥50 years) able to stand and walk independently were classified as symptomatic (SUI) if they reported stress related leakage and had an elevated International Consultation on Incontinence Questionnaire-Short Form score, or as asymptomatic controls if they denied leakage and had minimal symptom scores. Primary outcomes were transperineal hip ultrasound α/β angles at rest and during Valsalva, PVR volume, navicular drop test (NDT), spinopelvic parameters (pelvic incidence, pelvic tilt, sacral slope), tibial and femoral torsion, and Q angles. Between group comparisons used parallel parametric and non parametric tests with Holm-Bonferroni correction, and within group correlations between PVR and alignment variables were assessed with Pearson and Spearman coefficients.
Interventions
None listed
Sponsors
Benha University
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
FEMALE
Age
50 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
post menoupausal women, who had at least 12 months of amenorrhea or follicle-stimulating hormone values within the menopausal range and who could stand and walk independently to allow lower-limb and alignment assessments. \-
Exclusion criteria
women with urge or mixed incontinence as the dominant symptom, prior pelvic floor or anti-incontinence surgery, severe pelvic organ prolapse (stage 3 or greater), or neurological conditions affecting bladder function or gait, as well as those with hip or spine surgery likely to alter spinopelvic parameters \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| hip ultrasound parameters | At a single study visit (baseline) | we measured hip ultrasound angles describing urethrovesical and retrovesical configurations at rest and during a Valsalva or valgus manoeuvre, expressed in degrees. Trained clinicians performed transperineal ultrasound examinations in the lithotomy or semi-recumbent position, capturing angle measurements at rest and during standardized Valsalva efforts; we then recorded the mean of repeated readings to reduce measurement error. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Lower-Limb and Foot Posture Measures | At a single study visit (baseline) | We assessed foot posture using the navicular drop test (NDT), recorded in millimetres as the vertical displacement of the navicular tuberosity between subtalar neutral and relaxed stance. We measured Q-angles (quadriceps angle) using both computed tomography (CT) and goniometric methods for the right and left lower limbs |
| Spinopelvic Alignment and Torsion | At a single study visit (baseline) | Spinopelvic parameters included pelvic incidence, pelvic tilt, and sacral slope, all measured in degrees from radiographic |
| Post-Void Residual Volume | At a single study visit (baseline) | We measured post-void residual volume in millilitres using standardized bladder ultrasound immediately after participants attempted to empty their bladder. |
Countries
Egypt
Contacts
CONTACTAliaa M Elabd, assistant professor
CONTACTOmar M Elabd, PhD
STUDY_DIRECTORAliaa M Elabd, assistant professor
Faculty of Physical Therapy, Benha University
Outcome results
None listed