The Effectiveness of Two‐Dimensional (2D) Transperineal Ultrasonography in the Diagnosis and Dynamics of Therapy in Women with Pelvic Floor Disorder

Abstract

Aim The height of centrum tendineum; depth of the m.bulbocavernosus and m. puborectalis; diastasis of the m.bulbocavernosus, as measured by two‐dimensional (2D) transperineal ultrasonography, are markers of the of pelvic floor conditions. In available medical literaturethere is little evidence on the objectification of sonographic parameters in the diagnosis and dynamics of therapy in women with pelvic floor disorder.Therefore, we assessed the effectiveness of 2D transperinealultrasonography in women before and after minimally invasive perineoplasty. 

Methods Prospective uncomparative study of 33 parous women with pelvic floor disorder examined with POP quantification (POP-Q) and 2D transperineal ultrasound before, during and 3 months laterafter minimally invasive perineoplasty with surgical thread "Long lift". Statistical analysis was undertaken using Python package SciPy.To check whether the data is normally distributed we used Kolomogorov-Smirnov criteria (scipy.stats.kstest). All background variables (BMI, age, period from first birth and parity) and ultrasound measurements were not normally distributed, hence we used nonparametric statistical criteria. We based on 99 percent confidence level, therefore p-value 0.01 andparameters lower than thatwere considered to be statistically significant.  

Results The most significant parameter was the diastasis of m. bulbocavernosus, which decreased 4.6 times in patients immediately after surgical treatment (0.2±0.13 cm vs.  0.92±0.18 cm, p <0, 01). Moreover, this effect continued 3 months after perineoplasty. In addition, transperineal ultrasound scanning showed that the height of centrum tendineum were 1,5 times more amongpatients immediately and 3 months after surgical treatment (0.62±0.12 cm vs. 0.98±0.1 cm and 0.62±0.12 cm vs. 0.98±0.1 cm, P <0, 01). Other ultrasound parameters - depth of the m.bulbocavernosus, depth of the m. puborectalis-  did not have statistically significant changes after perineoplasty. 

Conclusion In the course of our research, we have established that2D transperineal ultrasonography could be used not only for diagnosis, but alsofor the dynamicsof therapy in patients with pelvic floor disorder.