OP14.07: Identifying weak points of pelvic floor by sonoelastography in case of stress incontinence

The most common type of urinary incontinence is stress urinary incontinence (SUI), which is characterised by the involuntary loss of urine during everyday activities (e.g. exercising, coughing, sneezing). This compromising the quality of life for women. SUI presents as a consequence of lower urinary tract dysfunction coupled with weakened pelvic floor tissues. Primary issue is the lack of tissue support to the upper urethra and bladder outlet. The aim of our study to assess the condition of the pelvic floor tissues in women suffering from stress incontinence, and to map the weak points of the pelvic floor using ultrasound elastography. We recruited 40 patients for the study, from the Urogynecology Department of the Obstetrics and Gynecology Clinic at the University of Szeged. Half of the women were asymptomatic and formed the control group, while the other half suffered from stress incontinence. Two different ultrasound methods were employed in our research: I.) Transvaginal 2D ultrasound to examine the mobility of the bladder neck and urethra II.) Transvaginal sonoelastography to determine the elasticity of the paraurethral connective tissues, in 3 points: 1.) The tissue environment surrounding the internal sphincter muscle of the bladder 2.) The endopelvic fascia and tissue environment in the midsection of the urethra 3.) The tissues surrounding the external urethral orifice. Significant correlations were found between the mobility of the bladder neck - urethra and changes in the elasticity of the paraurethral connective tissues. The sonoelastography results showed a close relationship with the patient's age and BMI values. Sonoelastography is a non-invasive imaging method with the potential to semiquantitatively assess the elasticity properties of in-vivo tissues. We hope that our findings contribute to the objective assessment of incontinence and the monitoring of treatments effectiveness, last but not least it enables more effective personalised treatment methods.