Is Bariatric Surgery a Prophylaxis for Pelvic Floor Disorders?

Comparison of sensitivity and specificity of three-dimensional pelvic floor ultrasound and conventional ultrasound in pelvic floor assessment after delivery

OBJECTIVE

This study was designed to investigate the sensitivity and specificity of the three-dimensional (3D) pelvic floor ultrasound and the conventional ultrasound in pelvic floor assessment after delivery.

METHODS

A total of 108 patients with pelvic floor dysfunction treated in our hospital were selected as the study group, and another 108 healthy subjects were included as the control group. Both groups were diagnosed by conventional ultrasound and 3D pelvic floor ultrasound, and confirmed with pathological findings. The diagnostic results of the conventional ultrasound and 3D pelvic floor ultrasound were compared, and the diagnostic conditions of various indicators in the two groups were compared.

RESULTS

The numbers of true positive cases and true negative cases diagnosed by the conventional ultrasound were 84 and 90, respectively, while the numbers of true positive cases and true negative cases diagnosed by the 3D pelvic floor ultrasound were 8 and 102, respectively (P<0.05). The accuracy, specificity, and sensitivity of the conventional ultrasound were 80.6%, 83.3%, and 77.8%, respectively, which were lower than 94.4%, 96.3%, and 92.6% of the 3D pelvic floor ultrasound, respectively (P<0.05). The study group exhibited greater urethral rotation angle (URA), posterior urethrovesical angles (PUVA) under Vsalva maneuver, area of the pelvic hiatus (APH), cystoscopic descent distance, cervical descent distance, and PUVA at resting state (P<0.05), and smaller angle of urethral inclination (UI), anal levator-urethra gap (LUG), cervix-symphyseal distance (CSD), rectal ampulla-symphyseal distance (RSD) and bladder neck-symphysis pubis distance (BSD) compared with the control group (P<0.05).

CONCLUSION

The 3D pelvic floor ultrasound is more accurate, specific and sensitive than the conventional ultrasound in the assessment of postpartum pelvic floor function, which is worthy of wide application.

Pelvic, anorectal and urinary symptoms according to the nutritional status of adult women: A cross-sectional study

ABSTRACT To review the occurrence of pelvic, anorectal and urinary symptoms according to the nutritional status of adultwomen. Methods This is a cross-sectional study with 54 women, aged 18 to 35 years, divided into normal weight (<25kg/m2), overweight (25kg/m2 to 29.99kg/m2) and obesity (≥30kg/m2) according to the body mass index. The presence of pelvic floor muscle dysfunction symptoms was assessed by the Pelvic Floor Distress Inventory and the impact of these symptoms by the Pelvic Floor Impact Questionnaire. Descriptive and inferential statistics were used, with a significance level of 5%. Results Pelvic Floor Distress Inventory total score was 22.95 (SD=26.11) in the eutrophic group and 59.67 (SD=47.80) in the obesity group (p=0.01). Considering the scales, urinary symptoms were higher in obese women than in the eutrophic group (p=0.01). In the assessment of patients with each symptom, a difference (p<0.01) was observed in incomplete bowel emptying, in which the highest frequency occurred in overweight women (47.4%) compared to eutrophic and obese women (both 26.3%). Urinary incontinence symptoms (18.2% in eutrophic women, 27.3% overweight and 54.5% obese), stress urinary incontinence (8.3% eutrophic, 41.7% overweight and 50.0%, obese) and difficulty in emptying the bladder (0.0% eutrophic, 33.3% overweight and 66.7% obese) exhibited higher frequencies (p=0.03; p<0,01 and p=0.02, respectively) in obese women. Conclusion Symptoms of pelvic floor muscles dysfunction, especially urinary tract muscles, occur more frequently in obese adult women when compared to eutrophic women.