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Evaluation of pelvic structural abnormalities in primiparous women with stress urinary incontinence

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Abstract

Introduction and hypothesis

The objective was to evaluate the morphological characteristics of pelvic floor structure specific to de novo stress urinary incontinence (SUI) in primiparous women using three-dimensional (3D) reconstruction fusion technology based on static MRI combined with dynamic MRI.

Methods

Eighty-one primiparous women after the first vaginal delivery were studied, 40 with SUI and 41 without SUI. 3D reconstruction models based on static MRI were used to describe the anatomical abnormalities of pelvic floor tissues. Dynamic MRI was used to describe segmental activities of the urethra and vagina. The relationship between the morphometry and postpartum SUI was evaluated by logistic regression analysis and receiver operator characteristic curve.

Results

The differences in the distance from the bladder neck to the pubic symphysis (BSD), the angle between the posterior wall of the urethra and the anterior wall of the vagina, the width of the distal region of the vagina, urethral length, urethral compression muscle volume (CUV), and pubovisceral muscle volume, puborectal muscle volume, were measured, and except for the extremity of the anterior urethral wall, the total displacements (TDs) of the other sites between the two groups were statistically significant (p < 0.05). Logistic regression analysis showed that the BSD decreased, the CUV decreased, the TDs of the first site and the eighth site increment correlated significantly with postpartum SUI occurrence (p < 0.05).

Conclusions

3D reconstruction fusion technology provides an important support for a precise assessment of the pelvic floor dysfunction. The BSD, CUV, and iliococcygeus muscle volume have certain values in predicting de novo SUI after first vaginal birth.

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Data Availability

The data are not publicly available due to their containing information that could compromise the privacy of research participants. This study includes data and imaging from participants. For reasons of reverence, datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

This study was funded by grants from the National Natural Science Foundation of China (31871212, Lidong Zhai).

Author information

Author notes

  1. Li Shi and Yujiao Zhao contributed equally to this work.

Authors and Affiliations

  1. Department of Anatomy and Histology, School of Basic Medical Sciences, Tian** Medical University, Tian**, 300070, China

    Li Shi, Weijun Li & Lidong Zhai

  2. Department of Radiology, Tian** First Central Hospital, School of Medicine, Nankai University, Fukang Road No. 24, Nankai District, Tian**, 300192, China

    Yujiao Zhao, Lihua Chen & Wen Shen

Authors
  1. Li Shi
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  2. Yujiao Zhao
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  3. Weijun Li
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  4. Lihua Chen
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  5. Wen Shen
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Contributions

L. Shi: project development, data collection, manuscript writing; Y. Zhao: data collection, manuscript writing; W. Li: data analysis, manuscript writing; L. Chen: data collection, manuscript writing; W. Shen: data collection, manuscript writing; L. Zhai: administrative support, data collection, manuscript writing.

Corresponding authors

Correspondence to Wen Shen or Lidong Zhai.

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Ethical statement

The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). The study was approved by the Institutional Review Board (IRB) of Tian** first central hospital (registration ID2018NO22KY).

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Shi, L., Zhao, Y., Li, W. et al. Evaluation of pelvic structural abnormalities in primiparous women with stress urinary incontinence. Int Urogynecol J 35, 369–380 (2024). https://doi.org/10.1007/s00192-023-05675-2

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