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Understanding Incontinence

New developments in diagnosing stress incontinence

The specific physical traits of female stress incontinence have been difficult to evaluate, but new techniques are shedding light on exactly what’s happening.
Published by Jane Granger
New developments in diagnosing stress incontinence

Advancements in imaging and measuring of muscle function are improving the diagnosis of female stress incontinence and therefore, the most appropriate treatment. Please note though; these techniques are relatively new, so aren’t yet widely available.

MRO - open-configuration magnetic resonance imaging
The breakthrough with MRO is that it allows imaging while sitting and standing – as well as lying down. By looking at images this way, clinicians can see shifts in organ positions and the effect this, as well as weight bearing, has on the bladder. For example, the degree of prolapse is often seen to increase when sitting or standing – which is consistent with women reporting little or no leaking when lying down.

3D MRI pelvic reconstruction
The advantage of 3D MRI over 2D is the ability to quantify muscle volume and provide a more precise picture of the pelvic floor structure. This helps doctors determine precisely where everything is sitting and is particularly useful for planning any necessary surgery.

NIRS – Near-infrared spectroscopy
To date, this method has been used to look at the disease or injury of skeletal muscles (those connected to bones to move limbs and other mechanical functions) but has recently been explored to measure the function of the pelvic floor muscles. By detecting the concentration of oxygen in the muscle when it’s being used, doctors can accurately measure how well the pelvic floor is – or isn’t – functioning. This is measured in real time using a vaginal speculum.

By being able to understand and accurately measure the structure and function of the pelvic floor muscle, tailoring conservative therapies, such as exercise, should improve outcomes for women with stress incontinence.

As mentioned, some of these diagnostic tools are quite new so not readily available in Australia and New Zealand. If you think one of these might be of benefit in your situation, ask your health care professional (GP, gynaecologist, continence physiotherapist, urologic) about it. Remember too, to ask about costs and what is and isn’t covered.



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