Applied Research Of Transperineal Ultrasonography In The Evaluation Of Pelvic Organ Prolapse

Objective:To explore the floor anatomy and function change of female patients with pelvic organ prolapse(POP)by analyzing the characteristics of the pelvic ultrasound imaging via application of transperineal ultrasonography,and to assess the feasibility and clinical value of transperineal ultrasonography via analyzing various date and quantifying the ultrasound diagnostic criteria.Methods:Research objects: 63 patients with POP were obtained in the First Affiliated Hospital of Nanchang University including in-patient and out-patient during May 2014 to December 2016,control group was consisted of 40 patients.All patients were excluded from huge pelvic mass,pelvic surgery or recent take-in of hormone drugs.Examination items: Observing the ultrasonographic images of all patients,measuring parameters of Vertical Distance of Bladder Neck to Inferior Edge of Symphysis Pubica(BN-VD)?Vertical Distance of Cervix to Inferior Edge of Symphysis Pubica(C-VD),Vertical Distance of Rectal Ampulla to Inferior Edge of Symphysis Pubica(RA-VD)in the rest,valsalva,contractions periods and calculating the moving range according to the data.And then measuring Levator Hiatal Diameter(LHD),Levator Hiatal Lateral Diameter(LHLR),Levator Hiatal Perimeter(LHP),Levator Hiatal Area(LHA),Levator Ani Thickness(LAT).Statistical analysis:Statistical analysis were done by SPSS 19.0 software.The measured data were expressed as mean ± standard deviation(SD).Differences between groups were assessed by aired samples T test.P<0.05 was considered as statistical significance.Results:(1)There were no significant differences of age,BMI and reproduction among two groups(P>0.05).(2)There were significant differences of BN-CD,C-VD,RA-VD among these two groups in the rest,valsalva,anus contractions period,and BN-CD,C-VD,RAVD were smaller than that in control group(P<0.05).With no significance of moving range in these two groups(P>0.05).LAT of POP group were smaller than that in control group,LHD,LHLR,LHP,LHA of POP group were bigger than that in control group(P<0.05).(3)There was a significant difference of Levator ani muscle injury rate between POP group and control group(57.1% vs.12.5%)(P<0.05).(4)There was a good correlation of assessing I and II degree of prolapse by using transperineal ultrasonography and clinical POP-Q,the correlation coefficient was 0.46 and 0.83 respectively(P<0.05).(5)The area of LHA of these two groups under the curve in the valsalva period was 0.97(95% confidence interval,0.94,1.00).The best critical value was 18.25 cm2 with the sensitivity of 88.9% and specificity of 97.5%.Conclusion:The transperineal ultrasonography is of great assisted value in clinical application,since it can evaluate the location,quantization and quantification of POP and its quantification of POP is in good correlation with clinical POP-Q.