Value of transperineal three-dimensional ultrasonography in diagnosis of pelvic floor dysfunction.

OBJECTIVES

To investigate the correlation between 3-dimensional ultrasonography parameters and pelvic floor dysfunction (PFD) and its application value in diagnosis and treatment.

METHODS

Ninety-two patients with PFD and 22 without who underwent 3-dimensional ultrasonography were selected. Transperineal 3-dimensional ultrasonography was performed by Voluson E8 colour Doppler ultrasonography to analyse the anteroposterior diameter (LHAD), transverse diameter (LHLD), pelvic diaphragmatic hiatus area (LHA), and bladder neck mobility (BND) of the patients. Diagnostic sensitivity and specificity of ultrasound parameters in PFD were analysed using Receiver Operating Characteristic (ROC) curves. Paired sample t test was used to analyse the improvement of pelvic floor muscle training (PFMT) in patients with PFD.

RESULTS

Patients with PFD had significantly higher levels of △LHAD, △LHLD, △LHA, and BND than controls (all P < .01). Binary logistic regression analysis showed that △LHA or BND levels were independent risk factors for the development of PFD. The ROC results showed that the area under the ROC curve with BND level was the highest (0.917). The diagnostic sensitivity of BND in PFD was 100.0% and the specificity was 70.7%. In urinary incontinence (UI) patients, there was a significant positive correlation between the occurrence of UI and BND levels (all r > 0, P < .05). After PFMT treatment, the levels of △LHAD, △LHLD, △LHA, and BND in patients with PFD were significantly decreased (all P < .001).

CONCLUSIONS

The abnormal changes in the level of 3-dimensional ultrasound parameters can be used as a sensitive indicator to evaluate PFD and a guiding parameter for PFMT treatment.

ADVANCES IN KNOWLEDGE

The feasibility of operation and repetition by 3-dimensional pelvic floor ultrasonography could provide a reliable imaging basis for clinical diagnosis and treatment of patients with PFD.