Transabdominal ultrasonographic assessment of urinary bladder neck by shear wave elastography in patients with stress urinary incontinence in correlation with urodynamics findings

Background Stress urinary incontinence (SUI) is a common condition affecting females of different ages. Objectives and aim of work To evaluate the relation between urinary bladder neck elasticity (E) using non-invasive transabdominal shear wave elastography technique and the urodynamics findings (abdominal leak point pressure: ALPP) in SUI patients. Methods The study was carried out on 37 female patients with SUI symptoms. After clinical evaluation and performing urodynamics in the urology department to measure ALPP, Ultrasound Shear Wave Elastography (SWE) was performed in the radiology department on the urinary bladder neck and mean SWE was calculated in kPa. Results Urodynamics findings (ALPP) showed leakage in 19 patients (52.8%) and no leakage in 17 patients (47.2%) of our clinically diagnosed SUI patients. All SWE values showed a statistically significant lower kPa among patients who have positive leakage during urodynamic testing ( p < 0.05). The average bladder SWE value was significantly lower among positive leakage patients with mean values 18.4 ± 3.5 kPa versus 25.6 ± 4.1 kPa in no leakage patients with p value < 0.001. SWE findings were consistent with urodynamics findings with level of agreement 72.2%, and p value < 0.001, diagnostic indices were sensitivity 88.89%, specificity 83.33%, and accuracy 86.11%. Conclusion SWE is a promising noninvasive modality in evaluation of SUI.