The Influence of Age, BMI, and Parity on 3D MRI-Derived Morphology of Pelvic Floor Muscle and Levator Ani Hiatus in Women With Stress Urinary Incontinence

IF 1.8 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms Pub Date : 2026-06-25 DOI:10.1111/luts.70075

Muhammad Arslan Ghaffar, Bareera Ajmal, Abdourahaman Ibrahim M. Bakour, Armaghan Khalid, Haihong Jiang

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引用次数: 0

Abstract

Objective

To measure the morphology of the pelvic floor muscle and levator ani hiatus (LAH) using 3D MRI segmentation in females with (SUI) and to assess correlations with age, body mass index (BMI), and parity.

Methods

This study includes 80 patients with SUI who underwent 3.0 T pelvic MRI. Patients were grouped based on age, BMI, and parity. Manual segmentation and 3D modeling of the pelvic floor muscle and LAH were performed to get volumetric and dimensional measurements. Statistical analysis included Kruskal–Wallis, Mann-Witney, and post hoc testing to evaluate group variations.

Results

The cohort included patients from 20 to 90 years old (mean 53.9 ± 11.7), with a mean BMI of 25.3 ± 3.4 and a mean parity of 1.85 ± 1.03. Significant variations in LAM surface (H(2) = 6.650, p = 0.036), flatness (H(2) = 6.471, p = 0.039), median intensity (H(2) = 8.218, p = 0.016), and curvature mean (H(2) = 7.382, p = 0.025) among age groups. The greatest LAM surface rankings were found in the 50–65 age range, whereas the highest LAM flatness ranks were found in those over 65 years old. BMI demonstrated a limited association, with overweight/obese participants exhibiting 11.3% larger LAM surface area compared to normal/underweight individuals (p = 0.044, r = 0.225). No significant associations were found between parity and any pelvic floor morphometric parameters (all p > 0.05).

Conclusion

This study identifies age-dependent morphological changes in levator ani muscle architecture as the primary determinant of pelvic floor structural adaptation in women with stress urinary incontinence. These quantitative shape-based parameters offer novel diagnostic and therapeutic insights, advancing precision medicine approaches in urogynecological assessment and management.

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年龄、BMI和胎次对压力性尿失禁女性盆底肌和提肛肌间隙三维mri形态学的影响

目的：利用3D MRI分割技术测量女性SUI患者盆底肌和提肛肌裂孔（LAH）的形态，并评估其与年龄、体重指数（BMI）和胎次的相关性。方法：80例SUI患者行3.0 T骨盆MRI检查。患者根据年龄、BMI和胎次进行分组。对骨盆底肌肉和LAH进行手工分割和三维建模，以获得体积和尺寸测量。统计分析包括Kruskal-Wallis、Mann-Witney和事后检验来评估组间差异。结果：纳入患者年龄为20 ~ 90岁，平均53.9±11.7，平均BMI为25.3±3.4，平均胎次为1.85±1.03。LAM表面（H(2) = 6.650, p = 0.036）、平整度（H(2) = 6.471, p = 0.039）、中位强度（H(2) = 8.218, p = 0.016）和曲率平均值（H(2) = 7.382, p = 0.025）在各年龄组间存在显著差异。50-65岁年龄段的LAM表面排名最高，而65岁以上年龄段的LAM平整度排名最高。BMI显示出有限的关联，超重/肥胖参与者的LAM表面积比正常/体重不足的个体大11.3% （p = 0.044, r = 0.225）。胎次与任何盆底形态学参数之间无显著相关性（均p < 0.05）。结论：本研究确定了年龄依赖性肛提肌结构的形态学变化是压力性尿失禁女性盆底结构适应的主要决定因素。这些基于形状的定量参数提供了新的诊断和治疗见解，推进了泌尿妇科评估和管理的精准医学方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-

CiteScore

3.00

自引率

7.70%

发文量

审稿时长

>12 weeks

期刊介绍： LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.