Perineal Ultrasound, Post-Void Residual, and Lower-Limb Alignment in Stress Incontinence

We conducted an observational case-control study with coordinated cross sectional analyses of two anonymised datasets from a tertiary urogynecology outpatient clinic in Saudi Arabia. Postmenopausal women (≥50 years) able to stand and walk independently were classified as symptomatic (SUI) if they reported stress related leakage and had an elevated International Consultation on Incontinence Questionnaire-Short Form score, or as asymptomatic controls if they denied leakage and had minimal symptom scores. Primary outcomes were transperineal hip ultrasound α/β angles at rest and during Valsalva, PVR volume, navicular drop test (NDT), spinopelvic parameters (pelvic incidence, pelvic tilt, sacral slope), tibial and femoral torsion, and Q angles. Between group comparisons used parallel parametric and non parametric tests with Holm-Bonferroni correction, and within group correlations between PVR and alignment variables were assessed with Pearson and Spearman coefficients.

Inclusion criteria

post menoupausal women, who had at least 12 months of amenorrhea or follicle-stimulating hormone values within the menopausal range and who could stand and walk independently to allow lower-limb and alignment assessments.

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Exclusion criteria

women with urge or mixed incontinence as the dominant symptom, prior pelvic floor or anti-incontinence surgery, severe pelvic organ prolapse (stage 3 or greater), or neurological conditions affecting bladder function or gait, as well as those with hip or spine surgery likely to alter spinopelvic parameters

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