Do Yerim, Lim Youngeun, Lee Soohyun, Lee Haneul
Graduate School, Department of Physical Therapy, College of Health Science, Gachon University, Incheon 21936, Republic of Korea.
Department of Physical Therapy, College of Health Science, Gachon University, Incheon 21936, Republic of Korea.
Diagnostics (Basel). 2023 Sep 20;13(18):3002. doi: 10.3390/diagnostics13183002.
Pelvic floor muscles (PFMs) play a crucial role in maintaining pelvic organ support and continence. However, pelvic floor dysfunction (PFD), often resulting from insufficient PFM control, poses a substantial global health challenge for women. This study aims to explore the relationship between levator ani muscle elasticity when assessed through transperineal shear-wave elastography (SWE) and bladder base displacement, quantified using transabdominal ultrasonography (TAUS), as a means to comprehensively evaluate PFM function. A total of 42 nulliparous women participated in this study. Participants received instructions on proper PFM contractions using Kegel exercises. Levator ani muscle elasticity was assessed both at rest and during contractions using transperineal SWE, while bladder base displacement was simultaneously measured through TAUS. Repeated measures demonstrated strong intraclass correlation coefficients of 0.906 at rest and 0.687 during contractions for levator ani muscle elasticity. The mean elasticity values were 24.7 ± 4.5 kPa at rest and 62.1 ± 10.4 kPa during contractions. Additionally, the mean bladder base displacement was 7.2 ± 2.5 mm, and the normalized bladder base displacement via body mass index was 0.3 ± 0.1 mm. Significantly, a moderate correlation was identified between the PFM function, represented by the difference in levator ani elasticity during contractions and resting, and bladder base displacement (r = 0.486, = 0.001). These findings underscore the potential utility of transperineal SWE as a reliable and noninvasive method to assess levator ani muscle elasticity and, consequently, PFM function. In conclusion, this study sheds light on the interplay between PFM elasticity and bladder base displacement, offering insights into PFM function assessments. The observed correlation suggests the clinical relevance of SWE in providing valuable information for treatment planning in PFD. These findings contribute to a deeper understanding of PFM dynamics, ultimately aiding in the effective management of PFD among women.
盆底肌肉(PFMs)在维持盆腔器官支撑和控尿方面发挥着关键作用。然而,盆底功能障碍(PFD)通常由盆底肌肉控制不足引起,对全球女性健康构成了重大挑战。本研究旨在探讨经会阴剪切波弹性成像(SWE)评估的肛提肌弹性与经腹部超声检查(TAUS)量化的膀胱底部位移之间的关系,以此作为全面评估盆底肌肉功能的一种方法。共有42名未生育女性参与了本研究。参与者接受了使用凯格尔运动进行正确盆底肌肉收缩的指导。使用经会阴SWE在静息和收缩时评估肛提肌弹性,同时通过TAUS测量膀胱底部位移。重复测量显示,静息时肛提肌弹性的组内相关系数为0.906,收缩时为0.687。静息时的平均弹性值为24.7±4.5 kPa,收缩时为62.1±10.4 kPa。此外,膀胱底部平均位移为7.2±2.5 mm,通过体重指数标准化的膀胱底部位移为0.3±0.1 mm。值得注意的是,以收缩和静息时肛提肌弹性差异表示的盆底肌肉功能与膀胱底部位移之间存在中度相关性(r = 0.486,P = 0.001)。这些发现强调了经会阴SWE作为一种可靠且无创的方法来评估肛提肌弹性以及盆底肌肉功能的潜在实用性。总之,本研究揭示了盆底肌肉弹性与膀胱底部位移之间的相互作用,为盆底肌肉功能评估提供了见解。观察到的相关性表明SWE在为盆底功能障碍的治疗规划提供有价值信息方面具有临床相关性。这些发现有助于更深入地理解盆底肌肉动态,最终有助于有效管理女性的盆底功能障碍。