PURPOSE: We hereby developed a new method to evaluate POP dynamically in supine and standing position using transrectal ultrasonography (TRUS).
The aim of this study is to visualize descending and prolapsing of pelvic organs in real-time using dynamic TRUS. And, the obtained findings of dynamic TRUS were compared with intraoperative findings.
MATERIALS AND METHODS: A prospective analysis was carried out including 31 women with symptomatic POP. Before the surgical repair for POP, TRUS was performed by the operator separated from the surgeon, and the findings of TRUS were compared with the intraoperative findings focused on diagnosis of POP. The patients were put on the fluoroscopic tilting table for passive postural change from spine to standing position. After injection of sonographic jelly into the vaginal lumen, ultrasound probe was inserted into the rectum. As getting up the patient passively using the fluoroscopic tilting table, descent and prolapse of pelvic organs were dynamically evaluated in real-time.
RESULTS: Cystocele, uterine prolapse, and rectocele were dynamically observed in this procedure. Morphological detail of POP, such as movement, sliding, eversion, descent, and looseness of vaginal wall and bladder wall were successfully demonstrated in most of the cases. In total, dynamic TRUS showed the high values of sensitivity (85.0%), specificity (81.1%), positive predict value (77.3%), and negative predict value (87.8%).
CONCLUSION: We successfully demonstrated morphological conditions and dynamic changes of pelvic organs during passive postural change using dynamic TRUS in real-time. Dynamic TRUS can be a useful modality to visualize POP preoperatively.
Written by:
Minagawa T, Ogawa T, Ishizuka O, Nishizawa O. Are you the author?
Department of Urology, Shinshu University School of Medicine. ; ; ;
Reference: J Urol. 2014 Sep 11. pii: S0022-5347(14)04378-X.
doi: 10.1016/j.juro.2014.06.094
PubMed Abstract
PMID: 25219698