Diego Raimondo1, Laura Cocchi1, Antonio Raffone1,2, Simona Del Forno1, Raffaella Iodice1, Manuela Maletta1, Anna Chiara Aru1, Paolo Salucci1, Marco Ambrosio1, Antonio Mollo3, Aly Youssef4, Paolo Casadio1, Renato Seracchioli1. 1. Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy. 2. Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy. 3. Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, Baronissi, Italy. 4. Obstetrics and Feto-Maternal Medicine Unit, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy.
Abstract
OBJECTIVE: To assess the association between sonographic findings at transperineal ultrasound (TPU) and chronic constipation (CC) in women with endometriosis. METHODS: An observational prospective cohort study was performed by enrolling all women with endometriosis scheduled for surgery between September 2019 and October 2020. Women underwent TPU at rest and during Valsalva maneuver evaluating levator-hiatal-area (LHA), antero-posterior diameter (APD), and levator ani muscle (LAM) coactivation. Ultrasound findings were compared between women with and without CC in the whole study population, and subsequently in two subgroups (only ovarian endometriosis and deep infiltrating endometriosis [DIE]). RESULTS: In all, 87 women were enrolled: 29 (33%) with CC and 58 (67%) without CC. Women with endometriosis and CC showed a smaller LHA during Valsalva, less LHA and APD enlargement from rest to maximum Valsalva, and a higher prevalence of LAM coactivation compared with women without CC. In the ovarian subgroup, women with CC had smaller LHA at Valsalva, less enlargement of LHA and APD from rest to maximum Valsalva, and higher prevalence of LAM coactivation compared with non-CC patients. In the DIE subgroup, TPU did not significantly differ between CC and non-CC patients. CONCLUSION: TPU signs of pelvic floor muscle hypertonia are more frequent in endometriosis patients with CC compared with those without constipation, particularly in women affected by isolated ovarian endometriosis.
OBJECTIVE: To assess the association between sonographic findings at transperineal ultrasound (TPU) and chronic constipation (CC) in women with endometriosis. METHODS: An observational prospective cohort study was performed by enrolling all women with endometriosis scheduled for surgery between September 2019 and October 2020. Women underwent TPU at rest and during Valsalva maneuver evaluating levator-hiatal-area (LHA), antero-posterior diameter (APD), and levator ani muscle (LAM) coactivation. Ultrasound findings were compared between women with and without CC in the whole study population, and subsequently in two subgroups (only ovarian endometriosis and deep infiltrating endometriosis [DIE]). RESULTS: In all, 87 women were enrolled: 29 (33%) with CC and 58 (67%) without CC. Women with endometriosis and CC showed a smaller LHA during Valsalva, less LHA and APD enlargement from rest to maximum Valsalva, and a higher prevalence of LAM coactivation compared with women without CC. In the ovarian subgroup, women with CC had smaller LHA at Valsalva, less enlargement of LHA and APD from rest to maximum Valsalva, and higher prevalence of LAM coactivation compared with non-CC patients. In the DIE subgroup, TPU did not significantly differ between CC and non-CC patients. CONCLUSION: TPU signs of pelvic floor muscle hypertonia are more frequent in endometriosis patients with CC compared with those without constipation, particularly in women affected by isolated ovarian endometriosis.
Authors: Alicia María de Pedro Negri; María Jesús Ruiz Prieto; Esther Díaz-Mohedo; Rocío Martín-Valero Journal: Int J Environ Res Public Health Date: 2022-05-10 Impact factor: 4.614