Quantitative analysis of ureteral peristalsis in healthy women using transvaginal ultrasound combined with...

Abnormalities in ureteral motility often precede morphological changes, and early subtle lesions are easily overlooked, thereby increasing the risk of renal impairment. However, existing imaging assessments tend to focus on qualitative morphological analysis, and effective quantitative methods for assessing motility are still lacking.

This single-center prospective observational study of healthy adult women (age range: 24-48 years) aimed to evaluate the feasibility of transvaginal ultrasound (TVUS) combined with peristaltic analysis (PA) for quantitative analysis of ureteral peristaltic waves. A total of 61 complete peristaltic waves from 30 ureters were recorded during 60-s dynamic acquisitions.

The study included 15 healthy women whose ureteral peristaltic waves exhibited a regular unidirectional propagation pattern from the proximal (renal) end to the distal (bladder) end. Based on Shapiro-Wilk tests combined with histograms and Q-Q plots, all five peristaltic parameters exhibited non-normal distributions. The M (Q1, Q3) values were as follows: transmission distance 0.39 cm (0.21, 0.71); transmission velocity 2.50 mm/s (1.20, 4.20); transmission time 1.59 s (1.19, 2.31); peristaltic intensity 1.55 arbitrary units (0.85, 2.64); and peristaltic interval 20.51 s (14.55, 26.75). Linear mixed model analysis showed that left-sided peristaltic intensity was significantly higher than right-sided intensity (p = 0.025), and bladder volume was negatively associated with transmission distance (β = -0.005, p = 0.029). No other significant side differences or associations were observed.

This pilot study demonstrates that TVUS combined with PA is a feasible and non-invasive method for quantifying the dynamic characteristics of the pelvic segment of the ureter. Although these preliminary findings still need to be validated in larger pathological cohorts, this technique has exploratory potential for detecting early functional disorders associated with ureteral diseases.