scholarly journals EP22.06: The feasibility of translabial ultrasound assessment of pelvic organ prolapse based on preset reference lines in the pelvic MR imaging

2018 ◽  
Vol 52 ◽  
pp. 275-275
Author(s):  
S. Feng ◽  
H. Wang ◽  
J. Li ◽  
M. Zhou
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cheng Tan ◽  
Man Tan ◽  
Jing Geng ◽  
Jun Tang ◽  
Xin Yang

Abstract Objective The aim of this study is to examine the relationship between rectal–vaginal pressure and symptomatic rectocele in patients with pelvic organ prolapse (POP). Method Patients with posterior vaginal prolapse staged III or IV in accordance with the POP Quantitation classification method who were scheduled for pelvic floor reconstructive surgery in the years 2016–2019 were included in the study. Rectocele was diagnosed using translabial ultrasound, and obstructed defecation (OD) was diagnosed in accordance with the Roma IV diagnostic criteria. Both rectal and vaginal pressure were measured using peritron manometers at maximum Vasalva. To ensure stability, the test was performed three times with each patient. Results A total of 217 patients were enrolled in this study. True rectocele was diagnosed in 68 patients at a main rectal ampulla depth of 19 mm. Furthermore, 36 patients were diagnosed with OD. Symptomatic rectocele was significantly associated with older age (p < 0.01), a higher OD symptom score (p < 0.001), and a lower grade of apical prolapse (p < 0.001). The rectal–vaginal pressure gradient was higher in patients with symptomatic rectocele (37.4 ± 11.7 cm H2O) compared with patients with asymptomatic rectocele (16.9 ± 8.4 cm H2O, p < 0.001), and patients without rectocele (17.1 ± 9.2 cm H2O, p < 0.001). Conclusion The rectal–vaginal pressure gradient was found to be a risk factor for symptomatic rectocele in patients with POP. A rectal–vaginal pressure gradient of > 27.5 cm H2O was suggested as the cut-off point of the elevated pressure gradient.


Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 98
Author(s):  
Gina Nam ◽  
Jae-Yen Song ◽  
Sa-Ra Lee

The aim of this study was to compare the data obtained by a pelvic organ prolapse quantification (POP-Q) examination with the translabial ultrasound (TLUS) quantification of prolapse, using a new method of angle measurement. We analyzed the TLUS and POP-Q exam findings of 452 patients with symptoms of POP. The POP-Q system was used for clinical staging. TLUS was performed both at rest, and during the Valsalva maneuver after proper preparation. A horizontal reference line was drawn through the inferior margin of the symphysis pubis and the levator plate connected to the rectal ampulla, and the difference was calculated between the rest and the Valsalva maneuver. The Spearman’s correlation coefficient of agreement between the TLUS and the clinical POP-Q staging was used for statistical analysis. There was a weak degree of correlation between the POP-Q findings for the Ap parameter and our new angle measurement (rho = 0.17, p < 0.001). Thus, POP staging in conjunction with TLUS with this new angle measurement shows better agreement for the diagnosis of POP than POP-Q staging alone.


Radiographics ◽  
2000 ◽  
Vol 20 (6) ◽  
pp. 1567-1582 ◽  
Author(s):  
Harpreet K. Pannu ◽  
Howard S. Kaufman ◽  
Geoffrey W. Cundiff ◽  
René Genadry ◽  
David A. Bluemke ◽  
...  

2006 ◽  
Vol 194 (5) ◽  
pp. 1427-1433 ◽  
Author(s):  
Yvonne Hsu ◽  
Aimee Summers ◽  
Hero K. Hussain ◽  
Kenneth E. Guire ◽  
John O.L. Delancey

Author(s):  
Manli Wu ◽  
Xudong Wang ◽  
Zhijuan Zheng ◽  
Junyan Cao ◽  
Jing Xu ◽  
...  

Objective: To explore the impact of dominant prolapse in other compartments in assessing bladder prolapse, and to establish cutoffs for staging bladder prolapse among Chinese women using translabial ultrasound. Design: Prospective multicentre observational study. Setting: Tertiary referral urogynaecology unit. Population: A total of 741 women with symptoms of lower urinary tract dysfunction and/or pelvic floor dysfunction were included. Methods: Women underwent interview, pelvic organ prolapse quantification (POP-Q) examinations and 4D translabial ultrasounds. Main outcome measures: The ROC statistic was used to assess accuracy and define the optimal cutoffs. Results: The mean patient age was 42.7 years (range, 18-82). There were 456 women without dominant prolapse in the apical/posterior compartments and 285 women with dominant prolapse in the apical/posterior compartments. Among patients without and with dominant prolapse, similar cutoffs (-10.9 mm vs. -9.1 mm) were determined for predicting POP-Q stage ≥ 2 in the anterior compartment, with AUCs of 0.87 and 0.79, respectively. In contrast, significantly different cutoffs (-5.7 mm vs. +3.5 mm) were determined for predicting POP-Q stage ≥ 1 among patients with and without dominant prolapse, with AUCs of 0.85 and 0.77, respectively. Conclusion: Dominant prolapse in the apical/posterior compartments affected the accuracy and cutoffs of translabial ultrasound for staging bladder prolapse. Thus, competition of various organs in women with multi-compartment prolapse should be considered as a potential complicating factor in assessing pelvic organ prolapse. Funding: The study is supported by grants from the National Natural Science Foundation of China (No. 91859115). Key words: Bladder prolapse; translabial ultrasound.


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