Ji Runyan, Wu Jing, Xu Yanqing, Ji Hanzhen
Ultrasonography Department, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Jiangsu, PR China.
Ultrasonography Department, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Jiangsu, PR China.
Clinics (Sao Paulo). 2025 Apr 13;80:100656. doi: 10.1016/j.clinsp.2025.100656. eCollection 2025.
To investigate the combined effect of transperineal ultrasound and Shear Wave Elastography (SWE) in the evaluation and monitoring of pelvic floor functions after total hysterectomy.
Fifty-two women who planned to undergo total hysterectomy from January 2019 to December 2022 in Nantong Third People's Hospital were selected, and the pelvic floor functions were assessed using transperineal ultrasound combined with SWE. The dynamic alterations in pelvic floor functions at different time points were compared after hysterectomy. The differences in pelvic floor parameters were compared between Transabdominal Total Hysterectomy (TAH) and Laparoscopic Total Hysterectomy (LTH).
The Posterior Urethravesical Angle at rest and Valsalve maneuver (R-PUA, V-PUA), antero-posterior diameter of the hiatus at rest and Valsalve maneuver (R-HAPD, V-HAPD), and elastic modulus of left and right puborectalis at rest (R-L-PRE, R-R-PRE), the Urethral Rotation Angle (URA)were obviously higher at 3 mon after surgery than before surgery and at 1-mon after surgery; the bladder neck-symphyseal distance at rest and Valsalve maneuver (R-BSD,V-BSD), and the difference in elasticity between the left and right puborectalis muscles (L-∆E, R-∆E) were markedly lower at 3 mon than before surgery and at 1 mon after surgery; V-BSD, L-∆E, R-∆E were obviously decreased and the Bladder Neck Descen (BND), URA, V-PUA were obviously increased in the TAH group in comparison with the LTH group.
Pelvic floor functions start to be weak at 3 months after total hysterectomy. TAH causes more significant damage to the structures and functions of the pelvic floor.
探讨经会阴超声与剪切波弹性成像（SWE）联合应用于全子宫切除术后盆底功能评估及监测的效果。
选取2019年1月至2022年12月在南通市第三人民医院计划行全子宫切除术的52例女性，采用经会阴超声联合SWE评估盆底功能。比较子宫切除术后不同时间点盆底功能的动态变化。比较经腹全子宫切除术（TAH）和腹腔镜全子宫切除术（LTH）盆底参数的差异。
静息及缩肛动作时后尿道膀胱角（R-PUA、V-PUA）、静息及缩肛动作时裂孔前后径（R-HAPD、V-HAPD）、静息时左右耻骨直肠肌弹性模量（R-L-PRE、R-R-PRE）、尿道旋转角（URA）术后3个月明显高于术前及术后1个月；静息及缩肛动作时膀胱颈-耻骨联合距离（R-BSD、V-BSD）、左右耻骨直肠肌弹性差异（L-∆E、R-∆E）术后3个月明显低于术前及术后1个月；与LTH组比较，TAH组V-BSD、L-∆E、R-∆E明显降低，膀胱颈下移（BND）、URA、V-PUA明显升高。
全子宫切除术后3个月盆底功能开始减弱。TAH对盆底结构和功能的损伤更显著。
