Perineal Ultrasound, Post-Void Residual, and Lower-Limb Alignment in Stress Incontinence

Overview

Stress urinary incontinence (SUI) in postmenopausal women is traditionally considered a local pelvic floor disorder, but emerging evidence suggests that spinopelvic and lower limb alignment may also contribute to continence mechanisms. Transperineal ultrasound α/β angles and post void residual (PVR) volume are promising imaging markers that might capture this broader biomechanical phenotype. Objective To compare hip ultrasound α/β angles, PVR volume, and lower limb and spinopelvic alignment between symptomatic and asymptomatic postmenopausal women, and to explore within group correlations between PVR and musculoskeletal alignment variables.

We conducted an observational case-control study with coordinated cross sectional analyses of two anonymised datasets from a tertiary urogynecology outpatient clinic in Saudi Arabia. Postmenopausal women (≥50 years) able to stand and walk independently were classified as symptomatic (SUI) if they reported stress related leakage and had an elevated International Consultation on Incontinence Questionnaire-Short Form score, or as asymptomatic controls if they denied leakage and had minimal symptom scores. Primary outcomes were transperineal hip ultrasound α/β angles at rest and during Valsalva, PVR volume, navicular drop test (NDT), spinopelvic parameters (pelvic incidence, pelvic tilt, sacral slope), tibial and femoral torsion, and Q angles. Between group comparisons used parallel parametric and non parametric tests with Holm-Bonferroni correction, and within group correlations between PVR and alignment variables were assessed with Pearson and Spearman coefficients.

Conditions

Eligibility