Abstract
The data concerning epidemiological determinants of the bladder neck (BN) mobility are scarce. The aim of the study was to determine epidemiological features and identify factors influencing BN position at rest and BN mobility in patients without pelvic organ prolapse (POP). Seven hundred and ninety-six patients that attended two outpatient clinics were enrolled in the study. Position and mobility of the BN were measured with the use of pelvic floor ultrasound. Demographic and functional factors that were hypothesized to influence BN mobility were assessed. Vaginal deliveries (VDs) and age ≥65 were associated with lower BN position at rest. Higher BN mobility was observed in women with stress urinary incontinence (SUI). In obese women, higher BN position and lower BN mobility was observed compared to non-obese women, and it was correlated with longer urethras in this group of patients. VDs and their number were associated with increased BN mobility, independently of body mass index (BMI). To conclude, obesity, VDs, and age are factors associated with changes in bladder neck position at rest and its mobility. Higher BMI correlates with restricted BN mobility, and, therefore, the incidence of SUI in obese patients is probably not connected to BN hypermobility.
Highlights
The female urethra is a part of the urinary tract passing from the internal orifice at the bladder neck (BN) to external urethral orifice in the vaginal vestibule
As obesity is often connected with pelvic floor disorders, we performed the comparative analysis of obese and non-obese women and we showed that in both groups Vaginal deliveries (VDs) and age over 65 years were associated with lower BN position at rest (Table 2)
Obesity is associated with higher BN position, and it is dependent on the longer urethra in these women as compared to non-obese women
Summary
The female urethra is a part of the urinary tract passing from the internal orifice at the bladder neck (BN) to external urethral orifice in the vaginal vestibule. The external striated muscle part of the urethra is called the external urethral sphincter. It extends from the neck to the perineal membrane and accounts for 20–80% of the total urethral length, with the thickest part in the middle third of the urethra, the high-pressure zone [3]. The BN consists of the distal portion of the detrusor (including the trigone) and continues into the proximal urethra [2]
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