الفهرس 
ANATOMY AND PHYSIOLOGY OFOnly 14 pages are availabe for public view
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Abstract
According to the International Continence Society (ICS, 2002) urinary incontinence is a condition in which involuntary loss of urine is a social or hygienic problem and is objectively demonstrable.
Evaluation of patients suffering from urinary incontinence includes medical history, urinary diary and physical examination (2nd International Consultation on Incontinence, 2002). However, the bladder has been described as unreliable witness, that is why clinical assessment alone has been shown to be an ineffective way of assessing women with lower urinary tract dysfunction. That is to say that the laboratory urodynamic studies remain the investigation of choice despite that they are invasive (Robinson et al., 2002). Nevertheless, urodynamics can’t explain all the symptoms and hence the need for ambulatory urodynamics (Pannek and Pieper, 2008). Unfortunately urodynamics is not available in all the hospital, which makes it difficult sometimes to manage women with urinary incontinence.
Ultrasound imaging of the pelvic floor provides significant new information related to urinary incontinence. This non-invasive type of information is potentially of use in understanding the mechanisms of urinary continence, which is a silent epidemic severely
affecting the quality of life of women with urinary incontinence (Peng et al., 2007).
It can be done through abdominal, vaginal, perineal and rectal routes. It is attractive in allowing investigators to observe and measure anatomical landmarks. Ultrasound can be used to visualise fluid-filled structures without the use of a contrast medium. The main advantage of ultrasound is that no ionising radiation is used in imaging, thus examinations can be easily repeated (Sanders et al., 1995).
The 50 women in this study were divided into three categories: (group A) 20 women with a stress incontinence, (group B) 20 women with detrusor overactivity and (group C) 10 women with no urinary incontinence as the control.
The first part of the study evaluated the repeatability of the ultrasound finding during assessment of urinary stress incontinence.
Using t-test had confirmed that there is no statistical difference between the two investigators regarding the bladder wall thickness, urethral dilatation, urethral length and urethral angulations during resting as stringing as p were more than 0.05. Moreover, measuring the bladder symphysis pubis angel during rest did not showed statistical difference, but the statistical difference revealed during the straining as p was less than 0.05. This can explain that modern ultrasound examination allows
adequate measurement of the bladder wall thickness and the urethra in majority of circumstances.
Statistical analysis using t-test had showed difference (p less than 0.05) between both incontinent groups and the control regarding proximal urethral length, bladder wall thickness and urethral angulations during resting and straining. This reflects the importance of these parameters in the diagnosis of urinary incontinence by ultrasound.
The total urethral length and urethral dilation were statistically similar in the study group and the control (p more than 0.05). These parameters have no major role in the diagnosis of urinary stress incontinence.
Transvaginal ultrasound can provide accepted, inexpensive, valuable information that will help in the diagnosis of this condition through evaluation of the bladder wall thickness and urethral parameters in relation to clinical picture.