Meng Xie1, Xuyin Zhang2, Xiaodan Zhang2, Wenping Wang3, Keqin Hua4. 1. Department of Ultrasound, Obstetrics and Gynecology Hospital, Fudan University, 128 Shenyang Road, Shanghai, 200090, China. 2. Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, 128 Shenyang Road, Shanghai, 200090, China. 3. Department of Ultrasound, Zhongshan Hospital, Fudan University, 111 Yixueyuan Road, Shanghai, 200032, China. 4. Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, 128 Shenyang Road, Shanghai, 200090, China. huakeqinjiaoshou@163.com.
Abstract
OBJECTIVES: The aim of this study was to evaluate the stiffness variation of the levator ani in patients with stage I/II pelvic organ prolapse (POP) before and after Kegel exercises by transperineal elastography. METHODS: A total of 20 patients who were diagnosed with staged I/II POP underwent conventional transperineal ultrasound and elastography. For each patient, the levator ani was located and evaluated in the state of Valsalva. After Kegel exercises for 12 weeks, transperineal ultrasound and elastography were repeated. The elasticity images were assessed using a four-point scale scoring system. RESULTS: Of the 20 cases, four had an elastography score of 1, 14 had a score of 2, two had a score of 3, and no cases had a score of 4 in the levator ani before Kegel exercises. After Kegel exercises, one had an elastography score of 1, two had a score of 2, 15 had a score of 3, and two cases had a score of 4. The mean elastography score was statistically significantly higher for the levator ani after Kegel exercises (2.90 ± 0.48) than for the baseline score (1.90 ± 0.29) (p = 0.025). CONCLUSIONS: Transperineal elastography was an effective and useful tool in the evaluation of the levator ani in patients with POP-Q stage I/II before and after Kegel exercises.
OBJECTIVES: The aim of this study was to evaluate the stiffness variation of the levator ani in patients with stage I/II pelvic organ prolapse (POP) before and after Kegel exercises by transperineal elastography. METHODS: A total of 20 patients who were diagnosed with staged I/II POP underwent conventional transperineal ultrasound and elastography. For each patient, the levator ani was located and evaluated in the state of Valsalva. After Kegel exercises for 12 weeks, transperineal ultrasound and elastography were repeated. The elasticity images were assessed using a four-point scale scoring system. RESULTS: Of the 20 cases, four had an elastography score of 1, 14 had a score of 2, two had a score of 3, and no cases had a score of 4 in the levator ani before Kegel exercises. After Kegel exercises, one had an elastography score of 1, two had a score of 2, 15 had a score of 3, and two cases had a score of 4. The mean elastography score was statistically significantly higher for the levator ani after Kegel exercises (2.90 ± 0.48) than for the baseline score (1.90 ± 0.29) (p = 0.025). CONCLUSIONS: Transperineal elastography was an effective and useful tool in the evaluation of the levator ani in patients with POP-Q stage I/II before and after Kegel exercises.
Authors: Cristine Homsi Jorge Ferreira; Peter L Dwyer; Melissa Davidson; Alison De Souza; Julio Alvarez Ugarte; Helena C Frawley Journal: Int Urogynecol J Date: 2015-06-14 Impact factor: 2.894