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Evaluation of pelvic floor muscle by transperineal elastography in patients with deep infiltrating endometriosis: preliminary observation

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Abstract

Purpose

To assess the elasticity of the pelvic floor muscle (PFM) affected by deep infiltrating endometriosis (DIE) with transperineal elastography.

Methods

This prospective observational study included 88 patients who were diagnosed with DIE, ovarian endometrioid cyst, or ovarian teratoma. All the patients were assigned to one of the three groups and underwent transperineal elastography. The scoring system and strain ratio (SR) values were recorded and analyzed. Assessments were conducted at maximal Valsalva and under quiescent condition, respectively.

Results

The mean elastography score was statistically significantly higher for the levator ani of group I than groups II and III under quiescent condition. In addition, SR of the levator ani in group I was higher than that in groups II and III. However, at maximal Valsalva, the mean elastography score of group I was lower than that of groups II and III. In addition, SR of group I was lower than that of groups II and III.

Conclusion

The elasticity of the PFM in DIE patients could be qualitatively evaluated by transperineal elastography. The coordination of the PFM was injured and decreased elasticity appeared in DIE patients.

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References

  1. Giudice LC. Clinical practice. Endometriosis. N Engl J Med. 2010;362:2389–98.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Koninckx PR, Meuleman C, Demeyere S, et al. Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain. Fertil Steril. 1991;55:759–65.

    Article  CAS  PubMed  Google Scholar 

  3. Koninckx PR, Ussia A, Adamyan L, et al. Deep endometriosis: definition, diagnosis, and treatment. Fertil Steril. 2012;98:564–71.

    Article  PubMed  Google Scholar 

  4. Baker PK. Musculoskeletal origins of chronic pelvic pain—diagnosis and treatment. Obstet Ginecol Clin North Am. 1993;20:719–43.

    CAS  Google Scholar 

  5. FitzGerald MP, Kotarinos R. Rehabilitation of the short pelvic floor I: background and patient evaluation. Int Urogynecol J. 2003;14:261–8.

    Article  CAS  Google Scholar 

  6. Dos Bispo AP, Ploger C, Loureiro AF, et al. Assessment of pelvic floor muscles in women with deep endometriosis. Arch Gynecol Obstet. 2016;294:519–23.

    Article  PubMed  Google Scholar 

  7. Butrick CW. Pelvic floor hypertonic disorders: identification and management. Obstet Gynecol Clin North Am. 2009;36:707–22.

    Article  PubMed  Google Scholar 

  8. Raimondo D, Youssef A, Mabrouk M, et al. Pelvic floor muscle dysfunction on D/4D transperineal ultrasound in patients with deepinfiltrating endometriosis: a pilot study. Ultrasound Obstet Gynecol. 2017;50:527–32.

    Article  CAS  PubMed  Google Scholar 

  9. Lyshchik A, Higashi T, Asato R, et al. Thyroid gland tumor diagnosis at US elastography. Radiology. 2005;237:202–11.

    Article  PubMed  Google Scholar 

  10. Heim LJ. Evaluation and differential diagnosis of dyspareunia. Am Fam Physician. 2001;63:1535–44.

    CAS  PubMed  Google Scholar 

  11. Butrick CW. Pathophysiology of pelvic floor hypertonic disorders. Obstet Gynecol Clin North Am. 2009;36:699–705.

    Article  PubMed  Google Scholar 

  12. Yap EC. Myofascial pain—an overview. Ann Acad Med Singap. 2007;36:43–8.

    PubMed  Google Scholar 

  13. Mabrouk M, Raimondo D, Del Forno S, et al. Pelvic floor muscle assessment at -and 4-dimensional transperineal ultrasound in women with endometriosis, with or without retroperitoneal infiltration: a step towards complete functional assessment. Ultrasound Obstet Gynecol. 2018;52:265–8 (Epub ahead of print).

    Article  CAS  PubMed  Google Scholar 

  14. Xie M, Zhang X, Liu J, et al. Evaluation of levator ani with no defect on elastography in women with POP. Int J Clin Exp Med. 2015;8:10204–12.

    PubMed  PubMed Central  Google Scholar 

  15. Xie M, Zhang X, Zhang X, et al. Can we evaluate the levator ani after Kegel exercise in women with pelvic organ prolapse by transperineal elastography? A preliminary study. J Med Ultrasonics. 2018;45:437–41.

    Article  Google Scholar 

Download references

Acknowledgements

This study was supported by a grant from the fund for scientific research of Chinese Preventive Medicine Association (Grant no. 201809031).

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Author notes

  1. Meng Xie and Yu Feng contributed equally to this article. 

Authors and Affiliations

  1. Department of Ultrasound, Fudan University, 128 Shen Yang Road, Shanghai, 200090, China

    Meng Xie, Yu Feng & Yunyun Ren

  2. Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, 128 Shen Yang Road, Shanghai, 200090, China

    Xuyin Zhang & Keqin Hua

  3. Department of Ultrasound, Zhongshan Hospital, Fudan University, 111 Yi Xueyuan Road, Shanghai, 200032, China

    Wenping Wang

Authors
  1. Meng Xie
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  2. Yu Feng
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  3. Xuyin Zhang
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  4. Keqin Hua
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  5. Yunyun Ren
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  6. Wenping Wang
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Corresponding authors

Correspondence to Yunyun Ren or Wenping Wang.

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Conflict of interest

We declare that we have no conflicts of interest.

Ethical approval

The study design and protocol were approved by the Institutional Review Board of the Obstetrics and Gynecology Hospital of Fudan University, Shanghai, P. R. China. In addition, all patients gave written informed consent after the procedure was explained fully.

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Xie, M., Feng, Y., Zhang, X. et al. Evaluation of pelvic floor muscle by transperineal elastography in patients with deep infiltrating endometriosis: preliminary observation. J Med Ultrasonics 46, 123–128 (2019). https://doi.org/10.1007/s10396-018-0913-y

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  • DOI: https://doi.org/10.1007/s10396-018-0913-y

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