A novel scheme for studying pelvic floor stability in women with and without Stress Urinary Incontinence: An ultrasonic investigation

Background&Aim: Bladder Base Movement (BBM) as a set of sustainability indicators reflect the level of the pelvic floor stability will change with any change of status or applied perturbation. The adoption of proper body position to perform Pelvic Floor Muscle (PFM) training exercises for management of pelvic floor dysfunction including Stress Urinary Incontinence (SUI) is very important. This study was aimed to investigate the PF stability or continence status during different positional interventions in women with and without SUI by use of Trans Abdominal Ultrasonography (TAUS). Materials& Methods: A quasi-experimental study were conducted on 21 women with SUI and 20 matched healthy subjects, aged 33–50(42.7±4.7) and 30–48(39.2±5.4) years respectively. After collecting demographic information, we assessed BBM by using TAUS at rest, during PFM and Transversus Abdominis (TrA) contractions, with knee flexion with Straight Leg Raising (SLR). Repeated measures ANOVA, Independent t-test and Pearson correlation test were used to analysis the data. Values of p<0.05 were considered to be significant. Findings: Regarding to ultrasonic assessment, only the main effect of intervention was significant (F=80.6, p=0.00001). Knee flexion affected on BBM more positively in control group comparing patients group, Mean 6.3 Vs. 2.5 mm (p<0.05). There were no differences between cough & valsalva also TrA & PFM contractions on BBM in both groups (p>0.05). With increasing Body Mass Index (BMI) values, downward movement of BB increased during cough &valsalva(r=0.39, p=0.014). Conclusion: In sum up, patients with SUI should do PFM exercises in positions such as knee flexion that enhance the pelvic floor stability. We hope that future studies will improve our understanding of the apparent association between PFM activity and changing posture by using ultrasonic imaging and recording electromyography activity of PFM simultaneously.