Real-time three-dimensional perineal ultrasound in evaluation on curative effect of different surgical methods in patients with anterior pelvic floor prolapse / 中国医学影像技术

ABSTRACT

Objective: To explore the value of real-time three-dimensional perineal ultrasound in quantitative evaluation on the effect of different surgical procedures in patients with anterior pelvic floor prolapse. Methods: Totally 153 anterior pelvic organ prolapse patients were divided into 3 groups according to different surgical procedures, including modified laparoscopic paravaginal repair group (group A, n=28), simple modified anterior pelvic floor reconstruction group (group B, n=49) and modified anterior pelvic floor reconstruction and sacrospinous ligament suspension group (group C, n=76). Transperineal real-time three-dimensional ultrasound examination was performed before and 1, 3 and 6 months after operation respectively. The bladder neck-symphyseal distance (BSD), area of the levator hiatus (ALH), urethra rotation angle (URA) and bladder neck descent (BND) before and after operation were measured and compared, and the postoperative recurrence rates were compared. Results: The total changes of BSD, ALH, URA and BND were significantly different before operation, 1, 3 and 6 months after operation (all P<0.001). There were significant differences of all the 4 indexes before and after operation in all 3 groups (all P<0.008). In group A, all 4 indexes had significant differences between 3 and 6 months after operation (all P<0.008). Three months and 6 months after operation, URA and BND had significant differences (both P<0.008) in group B, but only BND had significant differences (P=0.005) in group C. Six months after operation, the recurrence rate in group C was lower than those in group A and group B (P=0.001, 0.034). Conclusion: Modified anterior pelvic floor reconstruction and sacrospinous ligament suspension has high stability and low recurrence rate. Real-time three-dimensional ultrasound can quantitatively evaluate the curative effect of anterior pelvic floor surgery.