Feasibility of transperineal ultrasound in quantitative assessment of posterior compartment prolapse [经会阴盆底超声定量评估后盆腔脱垂的可行性研究]

作者：Lin X.; Wu M.; Huang Z.; Xu J.; Wang X.; Chen Y.; Wu S.; 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(9): 771-776.

DOI：10.3760/cma.j.cn131148-20200501-00361

• Pelvic organ prolapse quantification
• Posterior compartment prolapse
• Transperineal ultrasound

Objective: To investigate the feasibility of transperineal ultrasound in quantitative assessment of posterior compartment prolapse among Chinese women. Methods: The prospective multicenter study enrolled 485 women between January 2017 and January 2019. All patients underwent a standard clinical interview, pelvic organ prolapse quantification (POP-Q) examination and transperineal ultrasound examination. Volume data of transperineal ultrasound examinations were obtained at rest and in maximal Valsalva maneuver. Results: The higher POP-Q stage of posterior compartment, the lower rectal ampulla position in maximal Valsalva maneuver (POP-Q stage=0 vs POP-Q stage=1, P<0.001; POP-Q stage=1 vs POP-Q stage≥2, P<0.001), and the greater rectal ampulla hypermobility (POP-Q stage=0 vs POP-Q stage=1, P<0.001; POP-Q stage=1 vs POP-Q stage≥ 2, P=0.007). The rectal ampulla position at rest and in maximal Valsalva maneuver and rectocele depth were correlated with prolapse symptoms (r=-0.200, P<0.001; r=-0.252, P<0.001; r=0.086, P=0.045). The corresponding cut-off values of rectal ampulla position in maximal Valsalva in diagnosing posterior compartment prolapse (POP-Q stage ≥1) and clinical significant posterior compartment prolapse (POP-Q stage ≥2) were 7.32 mm below the symphysis pubis and 12 mm below the symphysis pubis, respectively, with the area under the ROC curve as 0.75 and 0.85, respectively. Conclusions: The ultrasonic measurements by transperineal ultrasound is significantly associated with POP-Q examination in posterior compartment, and it is demonstrated as a useful tool in quantitative assessment of the severity of posterior compartment prolapse.

• 单位
  第四军医大学; 哈尔滨医科大学附属第二医院; 中山大学