Evaluation before the start of exercise of pelvic floor muscles for female stress urinary incontinence

Objectives<br>The purpose of this study was to clarify the morphological characteristics by cine MRI of the pelvic floor in patients with stress urinary incontinence before the start of exercise of the pelvic floor muscles.<br>Subjects and Methods<br>The subjects were 34 females who were recruited from the general public, and gave consent to this study. Differential diagnosis of stress urinary incontinence was performed by the pad test of the International Continence Society and the simplified diagnostic method of Nippon Medical School, and the subjects were classified into the control group (n=18) and incontinence group (n=16). As the mobility of the bladder neck region on cine MR images, the difference in the distance of the bladder neck region between during relaxation as the standard and each movement, such as abdominal compression and contraction of the pelvic floor muscles, was measured. The rates of changes in the distance of the bladder neck region caused by each movement in the control and incontinence groups were compared.<br>Results<br>All the subjects had stress urinary incontinence, and its severity was very mild to intermediate. The mobility of the bladder neck region observed by cine MRI was significantly higher during abdominal compression in the incontinence group than in the control group, and it was also significantly higher during abdominal compression under contraction of the pelvic floor muscles in the former than in the latter. Among the background factors, there was a significant difference in the birth weight of their children between the incontinence and control groups, but no significant differences in the remaining factors, such as the mean age, job, BMI, and the number of deliveries, were detected between the 2 groups.<br>Conclusions<br>In mild stress urinary incontinence in females, the mobility of the bladder neck region was high during abdominal compression. Furthermore, it was found that support of the bladder neck region by the pelvic floor muscles was low during abdominal compression under their contraction. Among the background factors, there was a significant difference in the birth weight of their children between the incontinence and control groups, but no significant differences in the remaining factors were detected between the 2 groups.