Urethral Rotation Research Articles

Vaginal childbirth and bladder neck mobility.

Hypermobility of the bladder base is a predictor of stress urinary incontinence (SUI) in the female and at least partly due to pregnancy and vaginal childbirth. The purpose of this study was to quantify the effect of vaginal parity and birthweight on anterior compartment relaxation. Retrospective observational study. Outpatient uroynaecological clinics. Five hundred and seventy three women seen for primary urogynaecological assessment. Files of patients seen by the first author for assessment and translabial ultrasound imaging at urogynaecological units in Brisbane and Sydney, Australia, were reviewed for routinely-collected obstetric data and imaging results. Ultrasound parameters of anterior vaginal wall descent such as urethral rotation on Valsalva manoeuvre, bladder neck position on Valsalva, bladder neck descent and maximal descent of a cystocele on Valsalva. ANOVA analysis demonstrated a highly significant relationship between vaginal childbirth and bladder neck position on Valsalva (p < 0.001), bladder neck descent (p = 0.002) and maximal descent of a cystocele (p = 0.001). A large part of this effect was seen after one vaginal delivery. There was a trend towards increased bladder neck mobility (p = 0.065) with vaginal operative deliveries. Maximal recorded birthweight did not correlate with parameters of hypermobility. Vaginal childbirth is strongly associated with increased anterior vaginal wall descent, with most of this effect being due to the first vaginal delivery.

Is the irritable bladder associated with anterior compartment relaxation? A critical look at the 'integral theory of pelvic floor dysfunction'.

The 'integral theory of pelvic floor dysfunction', first proposed by Petros and Ulmsten in 1990, claims that anterior vaginal wall relaxation is associated with symptoms of urgency, frequency, nocturia and urge incontinence. A retrospective study was designed to test this hypothesis. Imaging data and urodynamic reports from 272 women suffering from symptoms of lower urinary tract dysfunction were evaluated. Opening of the retrovesical angle, bladder neck descent, urethral rotation and descent of a cystocele during Valsalva were used to quantify anterior vaginal wall laxity. None of the tested parameters were associated with symptoms and signs of detrusor overactivity On the contrary, patients with higher grades of urethral and bladder descent were less likely to suffer from nocturia and urge incontinence and were less likely to have sensory urgency and detrusor instability diagnosed on urodynamic testing. The findings of this study therefore do not support this hypothesis of the 'integral theory'.

The Influence of Posture on Perineal Ultrasound Imaging Parameters

A prospective clinical study was carried out to evaluate the influence of posture on perineal ultrasound imaging parameters. One hundred and thirty-two consecutive women presenting with symptoms of lower urinary tract dysfunction were examined by multichannel videourodynamics and perineal ultrasound, both supine and standing. Ultrasound included color Doppler imaging when available, i.e. in a subgroup of 99 patients. The position of the bladder neck at rest was higher in the supine position (P<0.001) and it descended further on Valsalva (P < 0.001), to reach an almost identical final position. There was a higher degree of urethral rotation on supine imaging (P = 0.001). Urethral funneling on Valsalva was more likely in the erect position (P < 0.001), as was urine leakage documented by color Doppler imaging (P < 0.001). The effect of a pelvic floor contraction was not significantly influenced by posture. Imaging of the urethrovesical junction should be undertaken in both supine and erect positions to document optimally both hypermobility and funneling or leakage.

The urethral pressure profile and ultrasound imaging of the lower urinary tract.

In a prospective study 105 patients with symptoms of stress incontinence underwent video-urodynamic testing, including resting urethral pressure profilometry and translabial ultrasound. The urethral pressure profile (UPP) included maximum urethral closure pressure (MUCP), functional length (FL) and area under the curve (AUC). Ultrasound parameters included urethral thickness, urethral rotation and bladder neck descent, as well as funneling/opening of the internal urethral meatus on Valsalva maneuver. Levator contraction strength was assessed measuring the cranioventral displacement of the internal meatus. Negative correlations between UPP data and age, parity and previous surgery were observed which were consistent with literature data. There was a positive correlation between the urethral AP diameter on ultrasound and the MUCP, which agrees with reports showing reduced sphincter thickness or volume in stress-incontinent women. Hypermobility on ultrasound did not correlate with UPP data. However, a lower MUCP correlated with extensive opening of the bladder neck. Finally, there was a trend towards poorer pelvic floor function with lower MUCP measurements.

Two Years of Experience with the Urethral Rotation Operation for the Correction of Postoperative Urinary Incontinence

No AccessJournal of Urology1 Oct 1968Two Years of Experience with the Urethral Rotation Operation for the Correction of Postoperative Urinary Incontinence Francis A. Beneventi Francis A. BeneventiFrancis A. Beneventi More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)62557-6AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1968 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 100Issue 4October 1968Page: 488-491 Advertisement Copyright & Permissions© 1968 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Francis A. Beneventi More articles by this author Expand All Advertisement PDF downloadLoading ...

A New Operation for the Correction of Postoperative Urinary Incontinence in the Male Patient

No AccessJournal of Urology1 Nov 1966A New Operation for the Correction of Postoperative Urinary Incontinence in the Male Patient Francis A. Beneventi Francis A. BeneventiFrancis A. Beneventi More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)63343-3AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1966 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byResnick M and King L (2018) Use of the Leadbetter Anti-incontinence Procedure in ChildrenJournal of Urology, VOL. 116, NO. 3, (366-368), Online publication date: 1-Sep-1976.Jeffs R (2018) CommentJournal of Urology, VOL. 116, NO. 3, (368-368), Online publication date: 1-Sep-1976.Salcedo H (2018) Surgical Correction of Post-Prostatectomy Urinary Incontinence Using Marlex Mesh: Preliminary ReportJournal of Urology, VOL. 107, NO. 3, (440-441), Online publication date: 1-Mar-1972.Gross M (2018) Surgical Management of Postoperative IncontinenceJournal of Urology, VOL. 103, NO. 5, (615-618), Online publication date: 1-May-1970.Beneventi F (2018) Two Years of Experience with the Urethral Rotation Operation for the Correction of Postoperative Urinary IncontinenceJournal of Urology, VOL. 100, NO. 4, (488-491), Online publication date: 1-Oct-1968. Volume 96Issue 5November 1966Page: 740-742 Advertisement Copyright & Permissions© 1966 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Francis A. Beneventi More articles by this author Expand All Advertisement PDF downloadLoading ...