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Early changes of pelvic floor function after transabdominal hysterectomy observed with transperineal pelvic ultrasound
- MENG Jian, MA Lin, KAN Yanmin, WANG Yuan
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JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(8):
76-81.
doi:10.6040/j.issn.1671-7554.0.2016.1253
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Objective To observe the early changes of pelvic floor function after transabdominal hysterectomy(TAH). Methods A total of 40 patients received transperineal pelvic ultrasound examination 1 week before and 3 months after TAH. The ultrasonic parameters of the resting state, contracting state and maximum Valsalva maneuver were recorded, including the rotation angle of the bladder neck(△vBA), posterior urethrovesical angle on the maximum Valsalva condition(vUJV), bladder neck, vaginal fornix and anorectal junction descent on the maximum Valsalva condition(vBND, vFND, vAND), decrease of levator hiatus on the maximum Valsalva maneuver and on the anal sphincter contraction(△vM, △cM), and so on. The parameters were compared to analyze the changes of pelvic floor function. Results According to the results of pelvic ultrasound, pelvic floor dysfunction after TAH was diagnosed in 7 cases, including stress urinary incontinence in 2 cases, proctoptoma in 3 cases, stress urinary incontinence complicated with bladder prolapse in 1 case, stress urinary incontinence complicated with bladder prolapse and proctoptoma in 1 case. The postoperative ultrasonic parameters such as △vBA, vUJV, △vUIA, vBND, vFND, vAND, vsB, vsF, vsA, and △vM were increased, indicating that the activity of pelvic organs increased, and the abdominal pressure resistant 山 东 大 学 学 报 (医 学 版)55卷8期 -孟健,等.经会阴盆底超声观察40例患者经腹子宫全切除术后早期盆底功能的变化 \=-function of pelvic floor reduced. In addition, the postoperative ultrasonic parameters including vxB, vDxB, vxF, vxA, △cxB, △cyB, and △cM decreased, showing that pelvic floor muscles and ligaments support ability abated, and the contraction of levator ani decreased. There were significant differences in all of the above parameters(P<0.05). Conclusion After TAH, the pelvic floor function weakened at the early stage. Transperineal pelvic ultrasound might monitor the pelvic floor function dynamically to detect the impairment before clinical symptoms appear, and to provide quantitative basis for early intervention, delay or prevention of pelvic floor functional disorder.
