[Perineal ultrasound for diagnostics of male stress incontinence: comparative study on the application of urogynecological standards for men and women]. / Die Perinealsonographie zur Diagnostik der männlichen Belastungsinkontinenz : Eine Vergleichsstudie zur Anwendbarkeit von urogynäkologischen Standards bei Mann und Frau.

ABSTRACT

BACKGROUND: The diagnostic options for persistent urinary incontinence following prostatectomy are limited despite incidence numbers of up to 40%. Perineal ultrasound, which is already well established in urogynecology to quantify urethral mobility, can also be used for the diagnostics of incontinence in men. The present study investigated whether there is a difference in reproducibility concerning the quantification of urethral mobility between men and women. MATERIAL AND METHODS: A total of 27 men and 27 women aged 65-85 years participated in the study. All underwent perineal ultrasound examination following standardized criteria under the three conditions of rest, contraction and a Valsalva maneuvre. Ultrasound images were taken under each condition and given to two independent examiners for evaluation. For all conditions it was recorded which of the three reference points for the quantification of urethral mobility, the urethra, internal urethral meatus and the base of the urinary bladder, could be assessed. The results were compared by means of a coefficient of agreement (p0) and the difference of the results between the two groups was validated for statistical significance using Student's t-test. RESULTS: At a t-value of 1.58 (p=0.154) there were no significant differences in the reproducibility in visualizing the three sonographic reference points, the urethra, internal urethral meatus and the base of the urinary bladder, between men and women. CONCLUSIONS: Using perineal ultrasound for quantification of urethral mobility in the diagnostics of incontinence in men after prostatectomy is just as reproducible in men as in women. For both sexes the technique is comfortable and pain-free due to the non-invasive nature. Perineal ultrasound is a cheap, non-invasive and reproducible diagnostic procedure which can be recommended for the evaluation of incontinence and the selection of a suitable surgical procedure also in men.