Four-Dimensional Introital Ultrasound in Assessing Perioperative Pelvic Floor Muscle Functions of Women with Cystoceles

2020 ◽  
Author(s):  
Wen-Chen Huang ◽  
Jenn-Ming Yang ◽  
Hsin-Fu Chen
Keyword(s):  
Confidence Interval ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Levator Avulsion ◽  
Introital Ultrasound ◽  
Ultrasound Measurements ◽  
Tomographic Ultrasound Imaging ◽  
Ultrasound Parameters

Abstract Purpose Research on the use of ultrasound to explore the pelvic floor in women is rarely done with introital ultrasound. This study aimed to investigate the performance of four-dimensional (4D) introital ultrasound in the perioperative assessment of pelvic floor muscle (PFM) function in women with cystocele. Materials and Methods The reliability and agreement of ultrasound measurements were determined by intraclass correlation coefficients (ICC) with 95 % confidence interval and Bland-Altman analysis in 20 women. The validity of ultrasound parameters was assessed by correlating squeezing ultrasound measurements with the modified Oxford scale (MOS) in 317 women. 4D introital ultrasound data of 241 women with (n = 29) and without (n = 212) postoperative cystocele at the 12-month postoperative assessment were retrospectively analyzed. Levator avulsion was diagnosed using tomographic ultrasound imaging. Involuntary and voluntary PFM functions were explored by dynamic changes in the bladder neck and genital hiatus, respectively, upon coughing and squeezing on 4D introital ultrasound. Results The ICC for the reliability of all tested ultrasound parameters was good to very good. The changes and change ratios of most ultrasound measurements from resting to squeezing were fairly correlated with MOS. Women with postoperative cystocele demonstrated more rates of complete levator avulsion [41.3 % vs. 4.7 %, P < 0.001, odds ratio (OR) 14.26, 95 % confidence interval (CI) 4.88–42.42] and fewer rates of capable voluntary PFM contraction (65.5 % vs. 92.5 %, P < 0.001, OR 0.16, 95 % CI 0.06–0.43) than those without postoperative cystocele postoperatively. Conclusion 4D introital ultrasound is feasible to assess perioperative PFM function in women with cystocele.

scholarly journals Urinary incontinence and associated factors among pregnant women attending antenatal care in public health facilities of Mekelle city, Tigray, Ethiopia

2020 ◽  
Vol 16 ◽  
pp. 174550652095200
Author(s):  
Arsema Berhe ◽  
Abayneh Alamer ◽  
Kiflom Negash ◽  
Belete Assefa
Keyword(s):  
Public Health ◽  
Urinary Incontinence ◽  
Confidence Interval ◽  
Pelvic Floor ◽  
Pregnant Women ◽  
Odds Ratio ◽  
Associated Factors ◽  
Adjusted Odds Ratio ◽  
Pelvic Floor Muscle ◽  
Mekelle City

Background: Urinary incontinence is any involuntary leakage of urine. It has serious negative health impacts on quality of life in pregnant women. According to the scientific committee of the International Continence Society report, worldwide prevalence of urinary incontinence estimated ranges between 32% and 64% among pregnant women. However, there is scarcity of evidence on prevalence and associated factors of urinary incontinence in Ethiopia. Objective: The aims of this study were to assess prevalence and associated factors of urinary incontinence among pregnant women attending antenatal care in public health facilities of Mekelle city, Tigray, Ethiopia. Methodology: Institution-based cross-sectional study design was conducted. Data were collected using an interviewer-administered structured questionnaire. Physical examination was done to assess the strength of pelvic floor muscles. The data were entered to EPI Info version 7 and analyzed using SPSS version 23. Bivariate and multivariate logistic regression analyses were done to investigate the factors associated with urinary incontinence. Results: Among 317 respondents, the prevalence of urinary incontinence was 23%. The contributing factors that had statistically significant association with urinary incontinence were gestational age (adjusted odds ratio: 9.6 (1.87–49.39, 95%), parity (adjusted odds ratio: 6.32 (1.48–27.05), 95% confidence interval), prior miscarriage (adjusted odds ratio: 6.28 (2.15–18.28), 95% confidence interval), constipation (adjusted odds ratio: 8.25 (3.12–21.84), 95% confidence interval), respiratory problem (adjusted odds ratio: 6.31 (2.05–19.43), 95% confidence interval), and weak pelvic floor muscle (adjusted odds ratio: 7.55 (2.51–22.67), 95% confidence interval). Conclusion: The prevalence of urinary incontinence is moderate compared to other studies. Gestational age, parity, prior miscarriage, having constipation, having respiratory problem, and weak pelvic floor muscle had significant association with urinary incontinence. This finding will help to increase the awareness of health care professionals involved in the care of pregnant women about urinary incontinence.

scholarly journals Convergent Validity of the Fitbit Charge 2 to Measure Sedentary Behavior and Physical Activity in Overweight and Obese Adults

2020 ◽  
pp. 1-8
Author(s):  
Joanne A. McVeigh ◽  
Jennifer Ellis ◽  
Caitlin Ross ◽  
Kim Tang ◽  
Phoebe Wan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Confidence Interval ◽  
Sedentary Behavior ◽  
Convergent Validity ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Living Environment ◽  
Step Count ◽  
Activity Trackers ◽  
Relative Differences

Activity trackers provide real-time sedentary behavior (SB) and physical activity (PA) data enabling feedback to support behavior change. The validity of activity trackers in an obese population in a free-living environment is largely unknown. This study determined the convergent validity of the Fitbit Charge 2 in measuring SB and PA in overweight adults. The participants (n = 59; M ± SD: age = 48 ± 11 years; body mass index = 34 ± 4 kg/m2) concurrently wore a Charge 2 and ActiGraph GT3X+ accelerometer for 8 days. The same waking wear periods were analyzed, and standard cut points for GT3X+ and proprietary algorithms for the Charge 2, together with a daily step count, were used. Associations between outputs, mean difference (MD) and limits of agreement (LOA), and relative differences were assessed. There was substantial association between devices (intraclass correlation coefficients from .504, 95% confidence interval [.287, .672] for SB, to .925, 95% confidence interval [.877, .955] for step count). In comparison to the GT3X+, the Charge 2 overestimated SB (MD = 37, LOA = −129 to 204 min/day), moderate to vigorous PA (MD = 15, LOA = −49 to 79 min/day), and steps (MD = 1,813, LOA = −1,066 to 4,691 steps/day), and underestimated light PA (MD = −32, LOA = −123 to 58 min/day). The Charge 2 may be a useful tool for self-monitoring of SB and PA in an overweight population, as mostly good agreement was demonstrated with the GT3X+. However, there were mean and relative differences, and the implications of these need to be considered for overweight adult populations who are already at risk of being highly sedentary and insufficiently active.

Accuracy and Reproducibility of the Peritoneal Cancer Index in Advanced Ovarian Cancer During Laparoscopy and Laparotomy

2013 ◽  
Vol 23 (9) ◽  
pp. 1699-1703 ◽  
Author(s):  
Sébastien Gouy ◽  
Jérémie Belghiti ◽  
Catherine Uzan ◽  
Geoffroy Canlorbe ◽  
Tristan Gauthier ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Confidence Interval ◽  
Cytoreductive Surgery ◽  
Peritoneal Cancer Index ◽  
Intraclass Correlation ◽  
Advanced Ovarian Cancer ◽  
Correlation Coefficients ◽  
Peritoneal Cancer ◽  
Senior Surgeon ◽  
The Mean

BackgroundThe aim of this prospective study was to evaluate the accuracy of the peritoneal cancer index (PCI) between laparoscopy and laparotomy and to evaluate the reproducibility of this index between 2 surgeons (junior vs senior) in advanced-stage ovarian cancer (ASOC). In ASOC, the quality of cytoreductive surgery, which is the main prognostic factor, is correlated with the extent of the disease and thus with the PCI. The reliability of this scoring index between different surgeons during laparoscopy and laparotomy has not been investigated in this disease.MethodsBetween April 2010 and October 2011, for each of the 29 patients undergoing complete cytoreductive surgery, 1 senior surgeon and 1 junior surgeon quantified the PCI score at 3 time points on the same day: during laparoscopy and during laparotomy, at the beginning and at the end. A concordance analysis was conducted with Bland and Altman’s method and estimated by intraclass correlation coefficients.ResultsThere was high concordance of the PCI score between the junior and senior surgeons during the laparoscopic and laparotomic procedures: the mean differences were not significantly different from 0 (P< 0.05) and 95% limits of agreement were ±3.5 and ±3.0, respectively. Laparoscopy underestimated the PCI score by approximately 2 points compared to the beginning of the laparotomy: the mean biases were −2.0 (95% confidence interval, −2.8 to −1.2) for the senior surgeon and −2.2 (95% confidence interval, −3.1 to 1.3) for the junior surgeon.ConclusionsThe PCI is reproducible and reliable for evaluating peritoneal spread in ASOC.

scholarly journals Validation of new ultrasound parameters for quantifying pelvic floor muscle contraction

2009 ◽  
Vol 33 (4) ◽  
pp. 465-471 ◽  
Author(s):  
S.-H. Yang ◽  
W.-C. Huang ◽  
S.-Y. Yang ◽  
E. Yang ◽  
J.-M. Yang
Keyword(s):  
Pelvic Floor ◽  
Muscle Contraction ◽  
Pelvic Floor Muscle ◽  
Pelvic Floor Muscle Contraction ◽  
Ultrasound Parameters

scholarly journals Tomographic Ultrasound Imaging to Control the Placement of Tension-Free Transobturator Tape in Female Urinary Stress Incontinence

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Charlotte M. Gräf ◽  
Tomas Kupec ◽  
Elmar Stickeler ◽  
Tamme W. Goecke ◽  
Ivo Meinhold-Heerlein ◽  
...  
Keyword(s):  
Ultrasound Imaging ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Transobturator Tape ◽  
Urinary Stress Incontinence ◽  
Tension Free ◽  
Novel Approach ◽  
Tomographic Ultrasound Imaging ◽  
Subjective Cure

Purpose. The objective was to evaluate, by means of tomographic ultrasound imaging (TUI), the reliability of a novel approach for determining the position of the implanted tension-free transobturator tape (TOT). Furthermore, we analyzed the association between the position of the tape at rest and the subjective cure in stress incontinent women.Methods. This retrospective pilot study consists of 32 stress incontinent women, who underwent TOT procedure and routine sonographic control at day 1 postoperatively and at follow-up visit. TUI was applied on the resulting 4D volumes, thereby delivering 9 axial slices with a 4 mm interslice distance starting at the meatus urethrae internus in caudal direction. The reliability of the approach was tested by two examiners. Postoperative and follow-up ultrasound parameters of uncured and cured patients were analyzed.Results. Measurements of the position of the TOT demonstrated high intraclass correlation coefficients. We found minor differences between sonographic parameters at day 1 postoperatively and at follow-up after a median period of 321 days. In cured patients, the position of the tape was measured in a more caudal position than in uncured patients.Conclusions. TUI can be a reliable method for determining the position of the tape. Further studies are needed to evaluate whether the postoperatively determined position can be used as an indicator of future subjective cure.

Clinical Utility of Ultrasound Measurements of Plantar Fascia Width and Cross-Sectional Area

2017 ◽  
Vol 107 (5) ◽  
pp. 375-381 ◽  
Author(s):  
Adebisi Bisi-Balogun ◽  
Michael Rector
Keyword(s):  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Plantar Fascia ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Plantar Surface ◽  
Plantar Fasciopathy ◽  
Ultrasound Measurements ◽  
The Mean

Background:We sought to develop a standardized protocol for ultrasound (US) measurements of plantar fascia (PF) width and cross-sectional area (CSA), which may serve as additional outcome variables during US examinations of both healthy asymptomatic PF and in plantar fasciopathy and determine its interrater and intrarater reliability.Methods:Ten healthy individuals (20 feet) were enrolled. Participants were assessed twice by two raters each to determine intrarater and interrater reliability. For each foot, three transverse scans of the central bundle of the PF were taken at its insertion at the medial calcaneal tubercle, identified in real time on the plantar surface of the foot, using a fine wire technique. Reliability was determined using intraclass correlation coefficients (ICC), standard errors of measurement (SEM), and limits of agreement (LOA) expressed as percentages of the mean. Reliability of PF width and CSA measurements was determined using PF width and CSA measurements from one sonogram measured once and the mean of three measurements from three sonograms each measured once.Results:Ultrasound measurements of PF width and CSA showed a mean of 18.6 ± 2.0 mm and 69.20 ± 13.6 mm2 respectively. Intra-reliability within both raters showed an ICC &gt; 0.84 for width and ICC &gt; 0.92 for CSA as well as a SEM% and LOA% &lt; 10% for both width and CSA. Inter-rater reliability showed an ICC of 0.82 for width and 0.87 for CSA as well as a SEM% and LOA% &lt; 10% for width and a SEM% &lt; 10% and LOA% &lt; 20% for CSA. Relative and absolute reliability within and between raters were higher when using the mean of three sonographs compared to one sonograph.Conclusions:Using this novel technique, PF CSA and width may be determined reliably using measurements from one sonogram or the mean of three sonograms. Measurement of PF CSA and width in addition to already established thickness and echogenicity measurements provides additional information on structural properties of the PF for clinicians and researchers in healthy and pathologic PF.

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