ROC Analysis and Significance of Transperineal Ultrasound in the Diagnosis of Stress Urinary Incontinence

Objective: To investigate the clinical significance of transperineal sonography in the diagnosis of stress urinary incontinence (SUI) in different degrees in primipara. Methods: Transperineal ultrasound was applied to observe primipara with SUI I grade (53 cases), SUI II grade (48 cases), SUI III (45 cases) and healthy women (55 cases), respectively. Pelvic morphological changes in the above group were compared and the parameters of bladder neck mobility, bladder angle urethral, rotation, urethral mouth funnel form under Valsalva action were recorded. The threshold values of all the parameters were determined by ROC curve analysis in order to discern the gold index of ultrasound in the diagnosis of SUI. The parameters of bladder neck mobility, bladder angle urethral, rotation and urethral mouth funnel form were higher in the SUI group with different grade than those in the control group, and all the above parameters were increased along with the grade increasing, and the difference was statistically significant (P < 0.01). The formation rate of urethral orifice in primipara with SUI II and SUI III grade was significantly higher than that with SUI I, and the difference was statistically significant (P < 0.01). ROC curve analysis showed that the AUC area of the indicator of combining neck mobility, bladder posterior angle, urethral rotation with urethral mouth funnel formation was 0.973, the value of sensitivity and specificity was 92.9% and 93.7%, respectively. Conclusion: Transperineal ultrasound could clearly observe the changes of pelvic floor structure in primipara with different degrees of SUI. The parameters obtained were correlated with SUI severity, and SUI parameters combined were obtained by ultrasonography which could exert high diagnostic value to contribute to the screening of SUI in primipara.