Analysis Of The Characteristics Changes In Women With Chronic Pelvic Pain Syndrome By Pelvic Ultrasonography

Objective:Chronic pelvic pain(CPP)is a very common disease,have a huge negative impact on the quality of women’s lives.Insidious onset of chronic pelvic pain,involves many factors and interaction of multiple systems,the diagnosis is more difficult to clear and targeted treatment.Now the chronic pelvic pain patients with clear cause have gradually been overcome,but the chronic pelvic pain syndrome(CPPS)without clear cause afflicted with pain.In recent years,as people for the pursuit of high quality health life,people have become increasingly aware of the importance of chronic pelvic pain,more aware of the importance of diagnosis and treatment of chronic pelvic pain syndrome,and was actively involved in related research.Compare the pelvic anatomy of female patients with chronic pelvic pain syndrome and normal female pelvic anatomy by using the two-dimensional and the three-dimensional ultrasound image check to discuss the characteristics changes in women with chronic pelvic pain syndrome by pelvic ultrasonography,and to provide evidences for the diagnosis and treatment of chronic pelvic pain syndrome,in order to provide the certain reference for prevention and treatment of chronic pelvic pain in clinical,promote patients’ recovery,relieve patients ’ pain,and ease patients ’ pain symptoms and improve life quality.Method:Collected 66 patients with chronic pelvic pain syndrome as the experimental group and 81 cases of without chronic pelvic pain syndrome as the control group in women randomly from Dalian Municipal Women and Children’s Medical Center Female Pelvic Floor Urinary Reconstructive Center in January 2015 to December 2016.The two groups of subjects fill out survey forms to collect demographic information and medical records.Through transperineal two-dimensional ultrasonography and transvaginal three-dimensional ultrasonography(360° rotation to produce a 3D image of the linear array probe)to acquire two-dimensional and three-dimensional ultrasonography in pelvic floor,at the same time to do the specialized pain examination in pelvic floor.The values of the distance between the bladder neck and the anterior inferior margin of the symphysis pubis(BND),the distance between the bottom of the bladder and the horizontal line of the anterior inferior edge of the pubic symphysis(BSD),the length of the urethra,the anteroposterior diameter of the genital tract,the anorectal angle were compared between chronic pelvic pain syndrome and control group under stationary and Valsalva state.The parameters of two groups were compared,such as the anteroposterior diameter,transverse diameter and area of the levator hiatus,the area of the lateral vaginal space,the area of the levator ani muscle,the thickness of the levator ani muscle,to find the characteristic changes.All statistical analysis was performed with the software SPSS21.0.Result:1.The static anteroposterior diameter of the genital tract in chronic pelvic pain syndrome groups was smaller than that in control group(53.23±7.70mm vs 56.72±10.19mm.P<0.05).The static anorectal angle in chronic pelvic pain syndrome groups was larger than that in control group(115.69°±13.28° vs 109.22°±13.03°,P<0.05).BSD was larger in chronic pelvic pain syndrome groups than that in control group(6.70±14.91mm vs-0.67±20.23mm,P<0.05)under the condition of Valsalva.2.The anteroposterior diameter of the levator hiatus(51.25±6.14mm vs 59.36±7.52mm),the transverse diameter of the levator hiatus(39.44±6.07mm vs 48.15±8.10mm),the area of levator hiatus(13.74±2.51 mm2 vs 18.54±3.58 mm2),the area of the left and right sides of the vaginal space(2.07±0.71mm2 vs 2.96±1.22 mm2,2.02±0.52 mm2 vs 2.87±0.90 mm2)were significantly lower in chronic pelvic pain syndrome group than those in control group(P<0.0001);while the thickness of the intermediate of levatorani muscle was lager in chronic pelvic pain syndrome group than that in control group(5.59±1.99mm vs 4.54±1.94mm,P<0.05).Conclusion:1.It showed that there are the characteristics of the levatorani muscle spasmin women with chronic pelvic pain syndrome detected by pelvic ultrasonography and the result suggests possible treat such patients through levatorani muscle spasmolysis therapy.2.The etiology and pathogenesis of chronic pelvic pain syndrome need multi-center,large prospective studies in the future to confirm.