Francisco J Orejuela1, Ka Lai Shek, Hans Peter Dietz. 1. Department of Obstetrics and Gynecology, University of Texas Health Science Center, Houston, TX, USA. Francisco.J.Orejuela@uth.tmc.edu
Abstract
INTRODUCTION AND HYPOTHESIS: The goal of the study was to define the time needed to obtain maximal organ descent and hiatal distension during Valsalva measured by transperineal ultrasound. Secondarily, we aimed to describe the timing of these events in relationship to each other. METHODS: We undertook a retrospective review of the stored ultrasound volume datasets of 50 patients with pelvic organ prolapse. Data on organ descent and hiatal distension were obtained in 10 volumes from rest to maximal Valsalva. RESULTS: On average, a Valsalva maneuver lasted 9.4 s (range 5 to 18). It took patients on average about six volumes (approximately 5-6 s) to reach 80% of maximum organ descent. The time to maximum organ descent was 8.9 s and the time to maximum distension of the levator hiatus was 8.2 s, p = 0.031. CONCLUSIONS: In order to obtain adequate assessment of pelvic organ prolapse, a Valsalva maneuver should last at least 6 s. Hiatal distension seems to precede pelvic organ descent.
INTRODUCTION AND HYPOTHESIS: The goal of the study was to define the time needed to obtain maximal organ descent and hiatal distension during Valsalva measured by transperineal ultrasound. Secondarily, we aimed to describe the timing of these events in relationship to each other. METHODS: We undertook a retrospective review of the stored ultrasound volume datasets of 50 patients with pelvic organ prolapse. Data on organ descent and hiatal distension were obtained in 10 volumes from rest to maximal Valsalva. RESULTS: On average, a Valsalva maneuver lasted 9.4 s (range 5 to 18). It took patients on average about six volumes (approximately 5-6 s) to reach 80% of maximum organ descent. The time to maximum organ descent was 8.9 s and the time to maximum distension of the levator hiatus was 8.2 s, p = 0.031. CONCLUSIONS: In order to obtain adequate assessment of pelvic organ prolapse, a Valsalva maneuver should last at least 6 s. Hiatal distension seems to precede pelvic organ descent.
Authors: R C Bump; A Mattiasson; K Bø; L P Brubaker; J O DeLancey; P Klarskov; B L Shull; A R Smith Journal: Am J Obstet Gynecol Date: 1996-07 Impact factor: 8.661
Authors: Julie A Tumbarello; Yvonne Hsu; Christina Lewicky-Gaupp; Suzan Rohrer; John O L DeLancey Journal: Int Urogynecol J Date: 2010-06-11 Impact factor: 2.894
Authors: Li Tan; Ka Lai Shek; Ixora Kamisan Atan; Rodrigo Guzman Rojas; Hans Peter Dietz Journal: Int Urogynecol J Date: 2015-06-14 Impact factor: 2.894
Authors: Hans Peter Dietz; Francesco Scoti; Nishamini Subramaniam; Talia Friedman; Ka Lai Shek Journal: Int Urogynecol J Date: 2018-03-12 Impact factor: 2.894