Correlation between levator hiatus area, pelvic organ prolapse quantification and prolapse symptoms [肛提肌裂孔与盆腔器官脱垂量化分期及脱垂症状的相关性分析]

作者：Wu M.; Lin X.; Wang X.; Fu Y.; Chen H.; Nan S.; Huang W.; Chen Y.; Wang L.; Jing C.; Chen W.; Tian J.; Zhang X.

来源：中华超声影像学杂志, 2020, 29(8): 700-705.

DOI：10.3760/cma.j.cn131148-20200325-00229

• Levator hiatus area
• Pelvic organ prolapse quantification
• Ultrasonography, transperineal

Objective: To investigate the association between levator hiatus area, pelvic organ prolapse quantification (POP-Q) examination and prolapse symptoms. Methods: The prospective multicenter study enrolled 996 female patients between January 2017 and January 2019. All enrolled patients underwent a standard clinical interview, POP-Q examination and transperineal ultrasound examination. Volume data of pelvic floor ultrasound examinations were obtained at rest, during contraction and during maximal Valsalva maneuver. The association between levator hiatus area, POP-Q examination and prolapse symptoms was analyzed. The performance of levator hiatus area on maximal Valsalva for assessing significant POP(POP-Q stage≥2) and prolapse symptoms were also evaluated. Results: There were significant differences of levator hiatus area at rest, during contraction and during maximal Valsalva among patients with different POP-Q stages (all P<0.001). Levator hiatus area during maximal Valsalva showed the highest correlation with abdominal dragging sensation (r=0.277, P<0.001). The area under the ROC curve (AUC) of levator hiatus area during maximal Valsalva for significant POP (POP-Q stage≥2) was significantly higher than that for prolapse symptoms (AUC: 0.77 vs 0.69, P<0.001). Conclusions: Levator hiatus area on transperineal has moderate correlation with POP-Q examination and their association is stronger than the correlation between ultrasound findings and prolapse symptoms.

• 单位
  中山大学; 第四军医大学; 哈尔滨医科大学附属第二医院