Bladder neck funneling on ultrasound cystourethrography in primary stress urinary incontinence: A sign associated with urethral hypermobility and intrinsic sphincter deficiency

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Objectives. To elucidate the implications of bladder neck funneling during straining in primary stress urinary incontinence. Methods. Ultrasonography was performed in 320 consecutive patients who underwent a full urodynamic study and whose only diagnosis was primary genuine stress incontinence. The ultrasound assessment included measurement of the bladder neck angle at rest and during stress, as well as observation of the development of bladder neck funneling during the Valsalva maneuver. Results. Of 320 study subjects, 111 had funneling of the bladder neck and 209 did not. Subjects with bladder neck funneling during stress had a significantly greater bladder neck angle at rest (P = 0.015) and during stress (P 2O; P = 0.003), larger volume of urine leakage on a pad test (P = 0.006), and higher peak flow on a pressure-flow study (P = 0.028) than did those without. Bladder neck funneling on ultrasonography had a sensitivity of 59.5% and a specificity of 68.6% for the detection of low leak point pressure. The negative predictive value was 92.8%. Conclusions. In primary genuine stress incontinence, bladder neck funneling on ultrasound cystourethrography implies the potential coexistence of poor anatomic support and an intrinsic sphincter defect, which require urodynamic investigation to verify. The high negative predictive value is useful in excluding the presence of low leak point pressure.

Original languageEnglish
Pages (from-to)936-941
Number of pages6
JournalUrology
Volume61
Issue number5
DOIs
Publication statusPublished - May 1 2003
Externally publishedYes

Fingerprint

Stress Urinary Incontinence
Urinary Bladder
Urodynamics
Pressure
Ultrasonography
Valsalva Maneuver
Observation
Urine

ASJC Scopus subject areas

  • Urology

Cite this

@article{be2b4dc6ffa748ed863e160c927087d1,
title = "Bladder neck funneling on ultrasound cystourethrography in primary stress urinary incontinence: A sign associated with urethral hypermobility and intrinsic sphincter deficiency",
abstract = "Objectives. To elucidate the implications of bladder neck funneling during straining in primary stress urinary incontinence. Methods. Ultrasonography was performed in 320 consecutive patients who underwent a full urodynamic study and whose only diagnosis was primary genuine stress incontinence. The ultrasound assessment included measurement of the bladder neck angle at rest and during stress, as well as observation of the development of bladder neck funneling during the Valsalva maneuver. Results. Of 320 study subjects, 111 had funneling of the bladder neck and 209 did not. Subjects with bladder neck funneling during stress had a significantly greater bladder neck angle at rest (P = 0.015) and during stress (P 2O; P = 0.003), larger volume of urine leakage on a pad test (P = 0.006), and higher peak flow on a pressure-flow study (P = 0.028) than did those without. Bladder neck funneling on ultrasonography had a sensitivity of 59.5{\%} and a specificity of 68.6{\%} for the detection of low leak point pressure. The negative predictive value was 92.8{\%}. Conclusions. In primary genuine stress incontinence, bladder neck funneling on ultrasound cystourethrography implies the potential coexistence of poor anatomic support and an intrinsic sphincter defect, which require urodynamic investigation to verify. The high negative predictive value is useful in excluding the presence of low leak point pressure.",
author = "Huang, {Wen Chen} and Yang, {Jenn Ming}",
year = "2003",
month = "5",
day = "1",
doi = "10.1016/S0090-4295(02)02558-X",
language = "English",
volume = "61",
pages = "936--941",
journal = "Urology",
issn = "0090-4295",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Bladder neck funneling on ultrasound cystourethrography in primary stress urinary incontinence

T2 - A sign associated with urethral hypermobility and intrinsic sphincter deficiency

AU - Huang, Wen Chen

AU - Yang, Jenn Ming

PY - 2003/5/1

Y1 - 2003/5/1

N2 - Objectives. To elucidate the implications of bladder neck funneling during straining in primary stress urinary incontinence. Methods. Ultrasonography was performed in 320 consecutive patients who underwent a full urodynamic study and whose only diagnosis was primary genuine stress incontinence. The ultrasound assessment included measurement of the bladder neck angle at rest and during stress, as well as observation of the development of bladder neck funneling during the Valsalva maneuver. Results. Of 320 study subjects, 111 had funneling of the bladder neck and 209 did not. Subjects with bladder neck funneling during stress had a significantly greater bladder neck angle at rest (P = 0.015) and during stress (P 2O; P = 0.003), larger volume of urine leakage on a pad test (P = 0.006), and higher peak flow on a pressure-flow study (P = 0.028) than did those without. Bladder neck funneling on ultrasonography had a sensitivity of 59.5% and a specificity of 68.6% for the detection of low leak point pressure. The negative predictive value was 92.8%. Conclusions. In primary genuine stress incontinence, bladder neck funneling on ultrasound cystourethrography implies the potential coexistence of poor anatomic support and an intrinsic sphincter defect, which require urodynamic investigation to verify. The high negative predictive value is useful in excluding the presence of low leak point pressure.

AB - Objectives. To elucidate the implications of bladder neck funneling during straining in primary stress urinary incontinence. Methods. Ultrasonography was performed in 320 consecutive patients who underwent a full urodynamic study and whose only diagnosis was primary genuine stress incontinence. The ultrasound assessment included measurement of the bladder neck angle at rest and during stress, as well as observation of the development of bladder neck funneling during the Valsalva maneuver. Results. Of 320 study subjects, 111 had funneling of the bladder neck and 209 did not. Subjects with bladder neck funneling during stress had a significantly greater bladder neck angle at rest (P = 0.015) and during stress (P 2O; P = 0.003), larger volume of urine leakage on a pad test (P = 0.006), and higher peak flow on a pressure-flow study (P = 0.028) than did those without. Bladder neck funneling on ultrasonography had a sensitivity of 59.5% and a specificity of 68.6% for the detection of low leak point pressure. The negative predictive value was 92.8%. Conclusions. In primary genuine stress incontinence, bladder neck funneling on ultrasound cystourethrography implies the potential coexistence of poor anatomic support and an intrinsic sphincter defect, which require urodynamic investigation to verify. The high negative predictive value is useful in excluding the presence of low leak point pressure.

UR - http://www.scopus.com/inward/record.url?scp=0038640108&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0038640108&partnerID=8YFLogxK

U2 - 10.1016/S0090-4295(02)02558-X

DO - 10.1016/S0090-4295(02)02558-X

M3 - Article

C2 - 12736011

AN - SCOPUS:0038640108

VL - 61

SP - 936

EP - 941

JO - Urology

JF - Urology

SN - 0090-4295

IS - 5

ER -