To explore the risk factors of stress incontinence with pelvic floor ultrasound data and related clinical data.

A total of 238 female patients who were admitted to Urology Department of the Third Affiliated Hospital of Sun Yat-sen University from October 2022 to October 2023 in need of perfect pelvic floor ultrasound examination were selected, including 123 in the stress incontinence group and 115 in the non-stress incontinence group. Clinical data and pelvic floor ultrasound data of all patients were collected. T test or Chi-square test were used for difference analysis to screen the risk factors of stress urinary incontinence. Secondly, multiple Logistic regression was used to further screen the independent risk factors of stress urinary incontinence. A prediction model of stress urinary incontinence was constructed according to the independent risk factors and the receiver operator characteristic curve of the model was drawn for verification. In addition, patients with stress urinary incontinence were divided into mild, moderate and severe groups according to the Incontinence Advisory Committee International Scoring Criteria (ICI Q-SF), and Chi-square test was used to analyze the differences in independent risk factors of pelvic floor among the three groups.

Multivariate Logistic regression showed that BMI≥24 kg/m², history of vaginal delivery, large fetal weight during delivery, increased bladder neck mobility, infundibular formation of internal urethral orifice, expansion of anal divider, cystocele and excessive movement of perineal body were closely related to the occurrence of stress incontinence, with statistical significance (P<0.05). Based on the results of multi-factor analysis, a prediction model for stress urinary incontinence was constructed. The area under ROC curve was 0.928(95%CI: 0.890-10.966, P<0.001), the optimal cut-off value of the model was 0.382, the sensitivity was 92.0%, and the specificity was 84.3%. In addition, compared with mild stress incontinence, the increased rate of bladder neck movement, the formation rate of inner urethral orifice funnel, the expansion rate of anal levator hiatus, the cystocele rate and the overmovement rate of perineal body were higher in patients with moderate and severe stress incontinence, and the differences were statistically significant (P<0.05).

The prediction model of stress urinary incontinence constructed by the combination of clinical data and pelvic floor ultrasound can provide a simple and scientific tool for clinical screening of females at high risk of stress urinary incontinence. The ultrasound data of pelvic floor may be the objective reference for the classification of stress urinary incontinence.