Assessment Of The Influence Of Total Hysterectomy On Pelvic Floor Function By Transperineal Ultrasonography

Objective:This study was aimed at observing the pelvic floor structure in normal non-fertile women and normal fertile women,and the changes of pelvic floor function in patients after total thysterectomy by two-dimensional ultrasound,and exploring the value of two-dimensional transperinealult rasonography in evaluating pelvic floor function of patients undergoing total hysterectomy.Methods: In this study,120 women were divided into three groups.Group ? included 30 normal non-fertile women,group ? included 40 women who had been given birth,group III included 50 patients who had been given birth and undergone total hysterectomy.The two-dimensional ultrasound was perpormed at rest and valsalva action to observe the mov-ement of pelvic floor organs.The following parameters were measured:bladder neck-symphyseal distance(BSD),bladder neck descent(BND),posterior urethrovesical angle(PUA),urethral angle(UTA),urethral rotationangle(UR),cervix-symphyseal distance(CSD),rectal ampulla-symphyseal distance(RSD).The age,height,weight,parity and BMI were collected at the same time.Result:1There were no statistical differences in BMI among the three groups(P>0.05).The age of group ? was younger than that of group? and group ?(P<0.05),but there were no statistical differences in age and parity between group ? and group ?(P>0.05).2 In group?,the two-dimensional ultrasound images showed pubic symphysis,bladder neck,urethra,vagina,rectum and anal canal in pelvic floor median sagittal section from ventral to dorsal side in order.The pelvic floor organs were located above the reference line at rest and maximum valsalva.3.1 There were no statistical differences in BSD and UTA among the three groups at rest(P>0.05),and the same was true for CSD at rest and maximum valsalva betweengroup ? and group ?(P>0.05).3.2 The size of BND,UR,PUA at maximum valsalva and UTA at maximum valsalva in each group was:group ? > group ? > group ?(P<0.05).3.3 The size of ASD and BSD at maximum valsalva in each group was: group ? > group ? > group?(P<0.05).3.4 The ASD at rest of group ? and group ? were smaller than those of group ?(P<0.05).There were no statistical differences in ASD at rest bet-ween group ? and group ?.3.5 The PUA at rest of group ? were bigger han those of group II and group II(P<0.05).There were no statistical differences in PUA at rest between group ?and group?(P>0.05).4 There were no obvious pelvic organ prolapse in group ?and group ?,while there were four cases of cystocele in group ?.There were no significant differences in cystocele rate among the three groups(P>0.05).Conclusion: 1 Two-dimensional transperineal ultrasound can be used to dynamically observe the anatomical structure,position and movement of female pelvic floor organs and to evaluate pelvic floor function.2Total hysterectomy,pregnancy and childbirth have a certain impact on female pelvic floor function,and the risk of PFD increases after total hysterectomy and childbirth.It is more valuable to measure the parameters under themaximal valsalva action after total hysterectomy by two-dimensional trans-perineal ultrasound.