The Preniminary Study Of Transperineal Ultrasonography In The Quantification Of Female Postpartum Anterior Compartment Organ Prolapse

ObjectiveThis study aims to establish the coordinate system by transperineal ultrasonography toobserve the ultrasonic features of the female postpartum anterior compartment organprolapse,To assess the clinical value of transperineal ultrasonography in the quantification ofanterior compartment organ prolapse and compare findings with clinical pelvic organ prolapsequantitive examination（POP-Q） assessments in this study.Methods(1) Total150primipara in postpartum were chosen as case group and were divided intopostpartum not prolapse group of50cases and postpartum prolapse group of100casesaccording to the postpartum diagnosis of anterior compartment organ prolapse,fifty normalyoung nulliparas were chosen as control group. All were examined by tow-dimensional pelvicultrasound at rest and on maximum Valsalva maneuver. The different states of midsagittal viewof the pelvic floor were obtained and were compared with those of normal nulliparas,includingthe angle between the central axis of the symphysis pubis and a line from the inferiorsymphyseal margin to the bladder neck,posterior urethrovesical,bladder neck-symphysealdistance,the angle between the posterior wall of bladder and any other fixed axis.Acomparative analysis of parameters was carried out separately for the case group and controlgroup.(2) The distance of internal urethral meatus (or the leading edge of a cystocele) relative tothe symphysis pubi of the patient with anterior compartment organ prolapse on Valsalva weremeasured, A comparative analysis of parameters was carried out between ultrasound andPOP-Q assessments obtained.Results(1) At rest and on maximum Valsalva maneuver, significant differences were foundbetween normal young nulliparous group and postpartum prolapse group except the posteriorurethrovesical.(2) At rest and on maximum Valsalva maneuver, no significant differences werefound between normal young nulliparous group and postpartum not prolapse group.(3) Onmaximal Valsalva maneuver,significant differences were found between postpartum prolapsegroup and postpartum not prolapse group except the posterior urethrovesical.(4) Fair to good correlations (r=0.70)were obtained between the POP-Q system and ultrasound quantification ofanterior compartment organ prolapse.(5) The mean value of the POP-Q system estimate andultrasound quantification of anterior compartment organ prolapse overall difference of1.0cmor so,with ultrasound estimate generally being more than1cm higher than the POP-Q system.Conclusions(1) Establish coordinate system by transperineal ultrasonography to observe primipara inpostpartum with anterior compartment organ prolapse,at rest the position of blddle and urethralhad been changed.On maximal Valsalva,bladder neck mobility significantly increased, theposterior wall of bladder down significantly.(2) Found the posterior urethrovesical cannot be used as ultrasonic index to evaluation theprimipara in postpartum with anterior compartment organ prolapse.(3)Transperineal ultrasonography can be used to evaluate anterior compartment organprolapse, Correlation with the clinical POP-Q system is good, and can be used as a clinicaleffective evaluation method of anterior compartment organ prolapse.