Use of Shear Wave Elastography to Evaluate Stress Urinary Incontinence in Women.

Objective: To compare the shear wave elastography (SWE) values of perineal tissues in female patients with stress urinary incontinence and those without incontinence.

Study Design: Prospective case control study.

Place And Duration Of Study: University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey from March 2019 to March 2020.

Methodology: Seventy women with stress urinary incontinence ranging between 40-70 years; and 30 women of similar age and weight without complaints of incontinence were selected as cases and control group, respectively. SWE values of the external urethral sphincter, bladder neck, mid-urethral and pubococcygeal muscle regions were measured dynamically, both at rest and during Valsalva manoeuver by transperineal ultrasonography. Moreover, the medial pubic symphysis of the participants was taken as a fixed point and the angle between the bladder neck and urethra was measured at rest and during Valsalva. Patients with incontinence were divided into groups, mild and severe, according to the bladder stress test results.

Results: The angle change was statistically significantly higher in the severe and mild groups than the control group (p <0.001). There was no statistically significant difference between the bladder neck region elastography values in Valsalva manoeuver between the control group and the mild group, but the difference in the severe group was statistically significantly lower (p = 0.005). No statistically significant difference was found between the control group and the mild group in terms of the mid-urethral region values at rest, but the difference in the severe group was statistically significantly lower (p ˂0.001).

Conclusion: SWE is a promising new imaging method in the evaluation of urethral hypermobility in stress urinary incontinence. Key Words: Ultrasonography, Shear wave elastography, Stress urinary incontinence, Transperineal ultrasonography.