Automated Ultrasound-Based Analysis of Urethral Kinematics in Stress Urinary Incontinence: A Pilot Study
Abstract
OBJECTIVES: Stress urinary incontinence (SUI) has been linked to excessive urethral mobility, yet clinical evaluation has been largely limited to assessing maximal excursion rather than capturing the full dynamics of visible urethral movement. In this study, we hypothesize that an automated, ultrasound-based method can objectively differentiate urethral mobility patterns between women with SUI and continent controls.
METHODS: We used a previously validated optical flow-based algorithm to automatically track urethral motion from transperineal ultrasound images during cough, Valsalva maneuver, and pelvic muscle contraction (PMC) in 11 women with SUI and 10 continent controls. Urethral motion was assessed by defining three regions of interest along the urethra (proximal, mid, and distal). Segmental urethral kinematics were computed and statistically compared between groups.
RESULTS: Substantial variability and overlap between groups were observed, with coefficient of variation ranging 25%-90%. On average, women with SUI demonstrated significantly larger urethral displacement compared to controls, particularly at the proximal segment during Valsalva (10.6 ± 1.2 mm vs. 6.0 ± 0.6 mm, p < 0.01), with pronounced inferior-posterior motion. Additionally, displacement between the upper and lower urethra was significantly larger in the SUI group (0.47 ± 0.10 mm/mm vs. 0.13 ± 0.03 mm/mm, p < 0.05), indicating localized hypermobility particularly near the proximal urethra.…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 11 participants or records.
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