OC09.07: Pelvic hiatal area measured by a novel 3D ultrasound technique in women with and without symptoms of pelvic floor dysfunction

Aim: To assess the reproducibility of pelvic floor biometric parameters by translabial three-dimensional ultrasound compared with the OmniView® reformatting technique. Material and methods: We performed a cross-sectional study involving 47 nulliparous women without symptoms of pelvic floor dysfunction. The hiatal area and right pubovisceral muscle width measurements were performed in the axial plane using both 3D ultrasound in the rendering mode and OmniView® techniques. To determine the occurrence of standardized error between examiners and the two sonographic methods, the paired t-test was used. The intra- and inter-observer reliability and agreement were estimated by concordance correlation coefficient (CCC) and limits of agreement, respectively. Results: We did not observe significant statistical differences among both measurements performed by the first examiner, both examiners and both methods in the assessment of the hiatal area; however, the measurements of the right pubovisceral muscle were significantly lower using OmniView®. The intra-observer reliability was good in the evaluation of all pelvic floor parameters; however, the inter-observer reliability was good only to the 3D rendering mode (CCC=0.87). The intra-observer agreement was good in the assessment of all pelvic floor parameters; however, the inter-observer agreement was found to be good only when 3DUS in the rendering mode was used (<±15%). Conclusion: Both 3D ultrasound in the rendering mode and OmniView® reformatting techniques were concordant in the assessment of pelvic floor parameters; however, the 3D ultrasound rendering in the mode demonstrated better inter-observer reliability and agreement.

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The Role of Gestational Diabetes Mellitus and Pelvic Floor 3D-Ultrasound Markers at the Second and Third Trimester of Pregnancy Predicting 6-18 Months Postpartum Urinary Incontinence: Preliminary Results From a Prospective Cohort

10.21203/rs.3.rs-985987/v1 ◽

2021 ◽

Author(s):

Carlos Izaias Sartorão Filho ◽

Fabiane Affonso Pinheiro ◽

Luiz Takano ◽

Raghavendra Hallur Lakshmana Shetty ◽

Sthefanie K. Nunes ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pelvic Floor ◽

Univariate Analysis ◽

3D Ultrasound ◽

Third Trimester ◽

The Third ◽

Hiatal Area

Abstract Background Gestational Diabetes Mellitus and long-term urinary incontinence (UI) have a severe impact on women's health. New methods to identify pregnant predictor risk factors of UI are needed. Our study investigated clinical and pelvic floor 3D-ultrasound markers in pregnant women at the second and third trimesters to predict 6-18 months postpartum UI. Methods This ongoing prospective cohort study included one hundred five nulliparous pregnant women with universal GDM screening and diagnosis, treated with nutritional and healthy lifestyle intervention. Pelvic floor 3DUltrasound was performed at the second and third trimesters of gestation. Clinical and pelvic floor 3DUltrasound biometry were collected. The ICIQ-SF and ISI questionnaires for UI were applied in the third trimester and 6-18 months postpartum. We performed univariate analysis (P<.20) to extract risk factors variables and multivariate logistic regression analysis (P<.05) to obtain the adjusted relative ratio for 6-18 months postpartum UI. Results In a preliminary result, a total of 93 participants concluded the follow-up. Using the variables obtained by the univariate analysis and after the adjustments for potential confounders, logistic regression analysis revealed that Gestational Diabetes Mellitus exposure was a strong and independent risk factor for 6-18 months postpartum UI (Adjusted RR 8.088; 95%CI 1.17-55.87; P:.034). In addition, higher hiatal area distension at rest from the second to the third trimester was negatively correlated with 6-18 months postpartum UI (Adjusted RR 0.966; 95%CI 0.93-0.99; P: .023). Conclusion Gestational Diabetes Mellitus was positively correlated with 6-18 months postpartum UI, and a higher hiatal area distension was negatively correlated with 6-18 months postpartum UI development. Trial registration: Regulatory approval was obtained from the Institutional Review Board (number 1.716.895) by “Botucatu Medical School of São Paulo State University (Unesp)” Ethics Committee.

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Three Dimensional Ultrasound of Pelvic Floor to Evaluate the Anatomical and Functional Changes of Primipara After Delivery

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2020.3029 ◽

2020 ◽

Vol 10 (6) ◽

pp. 1370-1373

Author(s):

Cheng Peng ◽

Beihua Kong

Keyword(s):

Pelvic Floor ◽

Ultrasound Examination ◽

Pelvic Floor Dysfunction ◽

Three Dimensional ◽

Levator Ani ◽

3D Ultrasound ◽

Control Group ◽

Imaging Method ◽

Levator Ani Muscle ◽

Observation Group

Objective: During pregnancy and childbirth, a series of remodeling processes may lead to the occurrence of pelvic floor dysfunction. Our aim was to explore the influence of different delivery methods on pelvic floor in primipara after delivery through three-dimensional (3D) ultrasound examination. Method: A total of 48 primiparas were selected as the study object. Among which, 21 primiparas underwent cesarean section were selected as observation group, 27 primiparas in vaginal delivery were selected as the control group. The 3D ultrasound examination of pelvic floor was carried out 6–8 weeks postnatally to observe and compare the prolapse of anterior, middle and posterior pelvic organs of parturient women in Valsalva movement. The posterior ureterovesical angel (PUA), urethral tilt angel (UTA), cervical mouth position (CMP), and bladder neck position (BNP) were measured. The changes of hiatus of levator ani muscle in patients with anal constriction, rest and Valsalva were observed and measured. Result: Compared with the data in control group, the number of cases of anterior, middle and posterior pelvic organ exfoliation in observation group was lesser, the UTA and BNP were higher, the CMP was lower, and the area of hiatus of levator ani muscle was smaller both at the time of calm, contraction and Valsalva movements. Conclusion: The damage of pelvic floor in primipara during transvaginal delivery is great. The 3D ultrasound is an objective and simple imaging method to screen the diseases of pelvic floor dysfunction.

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290: The Prevalence of Abuse in Women with Interstitial Cystitis and Pelvic Floor Dysfunction

The Journal of Urology ◽

10.1016/s0022-5347(18)32557-6 ◽

2006 ◽

Vol 175 (4S) ◽

pp. 96-97

Author(s):

Donna J. Carrico ◽

Ananias C. Diokno ◽

Kenneth M. Peters

Keyword(s):

Pelvic Floor ◽

Interstitial Cystitis ◽

Pelvic Floor Dysfunction

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Presumed IBS May Be Missed Pelvic Floor Dysfunction

Ob Gyn News ◽

10.1016/s0029-7437(05)70688-1 ◽

2005 ◽

Vol 40 (14) ◽

pp. 16

Author(s):

TIMOTHY F. KIRN

Keyword(s):

Pelvic Floor ◽

Pelvic Floor Dysfunction

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Pelvic floor dysfunction after levator trauma one year postpartum: a prospective case-control study

Geburtshilfe und Frauenheilkunde ◽

10.1055/s-0034-1374754 ◽

2014 ◽

Vol 74 (05) ◽

Author(s):

RM Laterza ◽

L Schrutka ◽

W Umek ◽

S Albrich ◽

H Koelbl

Keyword(s):

Pelvic Floor ◽

Case Control Study ◽

Pelvic Floor Dysfunction ◽

Case Control ◽

Levator Trauma ◽

One Year ◽

Control Study ◽

Prospective Case Control Study

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Possibilities of using neodymium laser (Nd:YAG) in patients with concomitant diseases which are accompanied by pathological discharge from the genital tract

GYNECOLOGY ◽

10.26442/20795696.2020.4.200277 ◽

2020 ◽

Vol 22 (4) ◽

pp. 75-81

Author(s):

Olga A. Pauzina ◽

Inna A. Apolikhina ◽

Darya A. Malyshkina

Keyword(s):

Drug Therapy ◽

Pelvic Floor ◽

Genital Tract ◽

Vaginal Discharge ◽

Muscle Tone ◽

Pelvic Floor Muscle ◽

Pelvic Floor Dysfunction ◽

Vaginal Wall ◽

Neodymium Laser ◽

Frequent Relapses

Background. Pathological vaginal discharge is the most common disorder in women after giving birth who have vaginal relaxation syndrome and vaginal wall prolapse, as well as in women during menopause. To date, there are no clear treatment regimens for mixed vulvovaginal infections, and the use of only drug therapy in patients with pelvic organ prolapse and genitourinary syndrome of menopause in combination with diseases which are accompanied by pathological vaginal discharge does not give a long lasting result and is characterized by frequent relapses. In this regard, the use of laser methods in combination with drug therapy may lead to the recovery of vaginal microbiocenosis and a decrease in the number of relapses of diseases which are accompanied by pathological discharge from the genital tract. Results. Description. This article presents a clinical case and description of the experience of using a neodymium laser for the treatment of a patient with recurrent mixed vulvovaginitis, 2nd- degree vaginal wall prolapse, loss of pelvic floor muscle tone, vaginal relaxation syndrome and sexual dysfunction using neodymium laser. The woman received 3 procedures of exposure to a neodymium laser with an interval of 2830 days. After 3 procedures of exposure to a neodymium laser, the patient has a good clinical efficacy in the recovery of vaginal microbiocenosis. Conclusions. An innovative technique of exposure to Nd:YAG neodymium laser in the practice of a gynecologist has shown high clinical efficiency in the treatment of not only pelvic floor dysfunction, but also mixed vulvovaginitis. And, despite this aspect of the use of laser technologies requires further study, we can use a neodymium laser in combination with traditional drug therapy to treat diseases which are accompanied by pathological discharge from the genital tract in cases of ineffective drug monotherapy and frequent relapses.

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