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Diagnostic value of pelvic floor ultrasonography for diagnosis of pelvic organ prolapse: a systematic review

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Abstract

Introduction and hypothesis

Pelvic organ prolapse (POP) is a common medical condition universally. In addition to physical examination, experts have increasingly turned their attention to ultrasound in diagnosing POP for its low cost and dynamic imaging. The aim of this paper is to provide an overview of the methods of pelvic floor ultrasound in diagnosing POP, which has been lacking up till now.

Methods

We included original papers comparing the outcome of the Pelvic Organ Prolapse Quantification system and ultrasound, published from 2008 to present in English, using electronic databases (MEDLINE, EMBASE, CENTRAL, PUBMED). All stages of the review were conducted in parallel by two reviewers.

Results

Fifteen papers were included. We found that current methods have advantages and limitations. The main methods are to measure levator hiatus-related parameters and distances between the lowest point of the pelvic organs and reference lines during Valsalva maneuver, contraction, and at rest.

Conclusions

Pelvic floor ultrasound is valuable in diagnosing POP, yet suffers from a weakness in precision compared with physical examination. From the existing research, we found that the differences in baseline data such as weight, height, ethnicity, etc., may affect the cutoffs of the above-mentioned parameters. Further research is required to find one appropriate cutoff for each parameter, even if it is necessary to set group values for every parameter according to varying situations.

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Acknowledgements

Foundation of Sichuan Provincial Science and Technology Program (Grant No. 2019YFH0147), Foundation of Chengdu Municipal Science and Technology Program (Grant No. 2018YF0500195SN) and Foundation of West China Second Hospital Program (Grant No. KX111) are acknowledged.

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Author notes

  1. Yuanjing Gao and Zhiwei Zhao contributed equally to this work

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, West China Second University Hospital, West China Campus, Sichuan University, No.17 People’s South Road, Chengdu, 610041, China

    Yuanjing Gao, Yanlin Yang, Meiqin Zhang & Yali Miao

  2. West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, China

    Zhiwei Zhao

  3. Deep Underground Space Medical Center, West China Hospital, Sichuan University, No. 37 Guoxuexiang, Chengdu, China

    Jiang Wu

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  1. Yuanjing Gao
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Correspondence to Jiang Wu or Yali Miao.

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The authors acknowledge the following financial support: Foundation of Sichuan Provincial Science and Technology Program (Grant No. 2019YFH0147); Foundation of Chengdu Municipal Science and Technology Program (Grant No. 2018YF0500195SN); Foundation of West China Second Hospital Program (Grant No. KX111).

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Appendices

Appendices

Appendix 1

Table 4 Measured levator hiatus area (HA)-related parameters to diagnose POP
Full size table

Appendix 2

Table 5 Measured reference line-related parameters to diagnose POP
Full size table

Appendix 3

Table 6 Other measured parameters to diagnose POP
Full size table

Appendix 4: search strategy

  1. a)

    Database: EBM Reviews—Cochrane Central Register of Controlled Trials, May 2019

    Search strategy:

    figure a
  2. b)

    Database: Embase, 1974 to 13 June 2019

    Search strategy:

    figure b
  3. c)

    Database: Ovid MEDLINE, 1946 to June week 2 2019

    Search strategy:

    figure c
  4. d)

    Database: PubMed, 1946 to 14 June 2019

    Search strategy:

    figure d

Appendix 5

Table 7 Quality assessment
Full size table

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Gao, Y., Zhao, Z., Yang, Y. et al. Diagnostic value of pelvic floor ultrasonography for diagnosis of pelvic organ prolapse: a systematic review. Int Urogynecol J 31, 15–33 (2020). https://doi.org/10.1007/s00192-019-04066-w

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