# A Multimodal Ultrasound Approach Combining Transperineal and Transrectal Shear Wave Elastography for Early Prediction of Stress Urinary Incontinence in Women

## TL;DR

This study combines ultrasound techniques to predict stress urinary incontinence in women, showing that urethral stiffness and bladder neck mobility are key indicators.

## Contribution

A novel multimodal ultrasound approach combining transperineal and transrectal shear wave elastography for early SUI prediction is introduced.

## Key findings

- Urethral stiffness measured by SWE was significantly lower in SUI patients compared to controls.
- A multifactorial model combining clinical and ultrasound parameters achieved high diagnostic accuracy (AUC 0.891).

## Abstract

This study aims to evaluate the diagnostic value of a novel multimodal approach combining transperineal ultrasound (TPUS), transrectal dual‐plane ultrasound, and shear wave elastography (SWE) in predicting stress urinary incontinence (SUI).

A total of 70 women diagnosed with SUI and 110 healthy controls were included. Clinical data such as age, body mass index (BMI), mode of delivery, and relevant medical history were collected. Pelvic floor ultrasound was performed using TPUS and transrectal dual‐plane ultrasound. Key parameters, including bladder neck mobility, urethral rotation angle, urethral length, and urethral stiffness measured by SWE, were recorded and analyzed. Statistical analysis was conducted using SPSS version 27.0, and a multifactorial predictive model was developed.

Significant differences were observed between the SUI and control groups in bladder neck mobility (p = .034), urethral rotation angle (p = .059), and urethral stiffness measured by SWE (p < .001). The average Young's modulus of the urethral sphincter was significantly lower in the SUI group (39.22 ± 5.83 kPa) compared to the control group (52.11 ± 9.24 kPa). Age and average urethral sphincter elasticity were identified as independent risk factors for SUI. The multifactorial model demonstrated high clinical applicability with an AUC of 0.891 (sensitivity: 84%, specificity: 80%).

The combination of TPUS, transrectal dual‐plane ultrasound, and SWE provides a reliable, non‐invasive diagnostic tool for predicting SUI. The study highlights the importance of urethral stiffness and bladder neck mobility in the pathophysiology of SUI. This multi‐modal approach shows strong potential for early detection and personalized treatment strategies. This multimodal approach offers a non‐invasive, reliable tool for early SUI detection and personalized management.