Infla10® Pulse™Also Known As
Urethral mobility, Vesical neck mobility, Bladder neck descent (BND), Urethrovesical mobility, Urethral hypermobility
Definition
Bladder neck mobility refers to the movement or displacement of the bladder neck (the junction between the bladder and urethra) during stress maneuvers such as coughing or the Valsalva maneuver.1 It is quantitatively defined as the difference between the bladder neck position at rest and during these stress maneuvers, typically measured in millimeters.2 Bladder neck mobility is an important physiological characteristic that has implications for urinary continence mechanisms.3 In clinical assessment, it is often evaluated using transperineal or pelvic floor ultrasound, which allows for real-time visualization of the bladder neck’s position and movement.4
Clinical Context
Bladder neck mobility is a significant clinical parameter in urogynecology and urology, particularly in the evaluation and management of stress urinary incontinence (SUI).1 Increased bladder neck mobility (hypermobility) has been associated with the occurrence of SUI, though this relationship is complex and multifactorial.2
Clinical assessment of bladder neck mobility is commonly performed using transperineal ultrasound, which provides a non-invasive method to visualize and measure the movement of the bladder neck during stress maneuvers.3 The cough stress test (CST) is frequently employed in clinical practice to induce stress on the bladder neck and observe its behavior, with several clinical practice guidelines recommending its use for the diagnosis of SUI.4
Various factors influence bladder neck mobility, including age, obesity, and obstetric history. Research has shown that vaginal deliveries and their number are associated with increased bladder neck mobility, independent of body mass index (BMI).1 Interestingly, in obese women, higher bladder neck position and lower bladder neck mobility have been observed compared to non-obese women, suggesting that the incidence of SUI in obese patients may not be primarily connected to bladder neck hypermobility.1
Pelvic floor muscle (PFM) strengthening exercises are commonly prescribed as a conservative treatment for urinary incontinence. Studies have demonstrated that PFM strengthening can significantly improve the ability of the pelvic floor muscles to elevate the bladder neck voluntarily, though it may not necessarily improve bladder neck stiffness during coughing or the Valsalva maneuver in women with SUI.3
Understanding bladder neck mobility is essential for clinicians in selecting appropriate treatment strategies for patients with urinary incontinence and other lower urinary tract symptoms.