{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:21:23Z","timestamp":1787505683719,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["NIH\u2010RC2\u2010DK\u2010122379"],"award-info":[{"award-number":["NIH\u2010RC2\u2010DK\u2010122379"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Stress urinary incontinence (SUI) has been linked to excessive urethral mobility, yet clinical evaluation has been largely limited to assessing maximal excursion rather than capturing the full dynamics of visible urethral movement. In this study, we hypothesize that an automated, ultrasound\u2010based method can objectively differentiate urethral mobility patterns between women with SUI and continent controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used a previously validated optical flow\u2010based algorithm to automatically track urethral motion from transperineal ultrasound images during cough, Valsalva maneuver, and pelvic muscle contraction (PMC) in 11 women with SUI and 10 continent controls. Urethral motion was assessed by defining three regions of interest along the urethra (proximal, mid, and distal). Segmental urethral kinematics were computed and statistically compared between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Substantial variability and overlap between groups were observed, with coefficient of variation ranging 25%\u201390%. On average, women with SUI demonstrated significantly larger urethral displacement compared to controls, particularly at the proximal segment during Valsalva (10.6\u2009\u00b1\u20091.2\u2009mm vs. 6.0\u2009\u00b1\u20090.6\u2009mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01), with pronounced inferior\u2010posterior motion. Additionally, displacement between the upper and lower urethra was significantly larger in the SUI group (0.47\u2009\u00b1\u20090.10\u2009mm\n                      <jats:italic>\/<\/jats:italic>\n                      mm vs. 0.13\u2009\u00b1\u20090.03\u2009mm\n                      <jats:italic>\/<\/jats:italic>\n                      mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), indicating localized hypermobility particularly near the proximal urethra. Maneuver\u2010specific differences were also noted within the SUI group, with Valsalva producing significantly larger and less uniform urethral movements compared to cough (10.6\u2009\u00b1\u20091.2\u2009mm vs. 6.6\u2009\u00b1\u20090.5\u2009mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our results demonstrate that the automated method is capable of capturing urethral mobility characteristics associated with SUI. Significant inter\u2010individual variability in both continent and SUI groups indicates that urethral kinematics are heterogeneous. The detailed kinematic data have the potential to identify distinct sub\u2010types of urethral mobility, facilitating systematic comparisons with underlying structural and neuromuscular defects. This approach can move clinical evaluation from simple group comparisons toward personalized SUI diagnosis and targeted treatment selection. Future studies with larger sample sizes and inclusion of additional pelvic floor conditions will be needed to validate these findings and advance their translation into clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nau.70231","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T10:46:46Z","timestamp":1770634006000},"page":"609-626","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Automated Ultrasound\u2010Based Analysis of Urethral Kinematics in Stress Urinary Incontinence: A Pilot Study"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5254-6705","authenticated-orcid":false,"given":"Kourosh","family":"Kalayeh","sequence":"first","affiliation":[{"name":"Department of Radiology University of Michigan Ann Arbor Michigan USA"},{"name":"Department of Urology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4536-3919","authenticated-orcid":false,"given":"J. Brian","family":"Fowlkes","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Michigan Ann Arbor Michigan USA"},{"name":"Department of Biomedical Engineering University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Daignault\u2010Newton","sequence":"additional","affiliation":[{"name":"Department of Urology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Payton","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1528-2787","authenticated-orcid":false,"given":"James A.","family":"Ashton\u2010Miller","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering University of Michigan Ann Arbor Michigan USA"},{"name":"Department of Mechanical Engineering University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John O.","family":"DeLancey","sequence":"additional","affiliation":[{"name":"Department of Urology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(12)91840-2"},{"key":"e_1_2_12_3_1","first-page":"91","article-title":"Correlative Study of Paraurethral Anatomy","volume":"68","author":"DeLancey J. 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