[Ultrasound of the urinary bladder neck: changes before and after pelvic floor muscle exercise]

It was repeatedly reported that training of pelvic floor muscles in the treatment of the stress type of urinary incontinence produced favourable results [1, 4, 6, 7, 8, 10]. The objective of the present study was to examine by ultrasound, using the transperineal route, the influence of exercise of pelvic floor muscles in the treatment of the stress type of incontinence on the position of the internal reproductive organs and the vesicourethral system. For exercise and strengthening of the muscles of the pelvic floor the intravaginal aid Kolpexin [7] was used. The authors investigated two parameters--the angle formed by the median axis of the symphysis with the imaginary line connecting the apex of the lower margin of the symphysis with the urethrovesical junction (angle U). The second parameter is the distance of the apex of the lower margin of the symphysis from the urethrovesical junction (line P). The authors recorded statistically significant changes of angle U before and after exercise of the pelvic floor muscles which were confirmed by ultrasonic examination. Changes in the length of line P were not statistically significant. Strengthening of the pelvic floor muscles was confirmed also by manometric examination. From a group of 20 patients 14 (70%) improved markedly after two months' exercise of the pelvic floor muscles and thus are free from complaints. Ultrasonic urogynaecological examination provides information on a change in the position of internal reproductive organs and the vesicourethral system and is one of the many methods which can confirm the effect of conservative or surgical treatment.