Objective: The objective of our study was to objectify a leak of urine during perineal ultrasound examination using a color doppler (CDV), and to compare it with some other ultrasound parameters. Design: A prospective, pilot study. Setting: Department of Gynecology - Obstetrics of the General Teaching Hospital and the 1st Medical Faculty of the Charles University in Prague, Apolinářská 18, 120 00 Praha 2. Methods: 20 women with stress type of incontinence were included in the study. For all women, we assessed the position and mobility of the bladder neck and we performed an examination using a color doppler (CDV). Thereafter, an introital examination followed to detect occurrence of funneling. Subsequently, we performed a perineal examination using an ultrasound contrast me- dium and the CDV, and we compared all examinations performed. Results: During examination without using a contrast medium, a leak of urine was diagnosed by CDV in 14 patients (70% sensitivity), and a funneling in 18 women (90% sensitivity). During exami- nation with a contrast medium, a funneling was present in all 20 patients. In 19 cases, a leak was detected using CDV after filling with a contrast substance (95% sensitivity). Conclusion: By a color doppler imaging (CDV) we can objectify a leak of urine, determine the position of urethra in which such leakage of urine occurs. A contrast medium significantly increases the sensitivity of doppler examination.

        Key words: GSI, perineal ultrasound, introital ultrasound, funneling, ultrasound contrast medium