[Ultrasonographic assessment of urethrovesical mobility in women]

It is widely accepted that preoperative evaluation of women with stress urinary incontinence should include an assessment of urethrovesical mobility. In the last few decades a variety of methods have been used to this purpose: the so-called Q-tip test, radiologic techniques and ultrasonic studies. Transvaginal and perineal ultrasonography allows the assessment of bladder neck and urethral axis mobility at rest, during cough, Valsalva maneuvre and pelvic floor contraction. The technique is simple, not invasive and without discomfort for the patients. Aim of this study is to assess the reproducibility of an ultrasonic technique that allows the measurement of bladder neck mobility (alpha-angle variation) and the angle of the mobile proximal tract of urethra (beta-angle). A total of 58 women were included: 23 with stress incontinence and 35 continent and asymptomatic controls. The technique allows reproducible measurement of alpha and beta angles. In stress incontinent group bladder neck mobility is significantly larger while urethral angle (beta-angle) is significantly smaller and is lowered by straining.