TY - JOUR AU - Orazov Mekan, AU - Lokshin Vyacheslav, AU - Toktar L.R., AU - Khamoshina M.B., AU - Gevorgian D.A., AU - Dostieva Sh.M., AU - Markina Y.V., AU - Lologaeva M.S., AU - Karimova G.A., PY - 2020/08/14 Y2 - 2024/03/29 TI - DIAGNOSTIC VALUE OF PELVIC FLOOR ULTRASONOGRAPHY FOR DIAGNOSIS OF PELVIC ORGAN PROLAPSE JF - Научный журнал «Вестник НАН РК» JA - ВНР VL - IS - 4 SE - Статьи DO - UR - https://journals.nauka-nanrk.kz/bulletin-science/article/view/583 SP - 49-54 AB - <p>Female pelvic floor dysfunction encompasses a number of prevalent clinical conditions, including<br>female pelvic organ prolapse, urinary and fecal incontinence, obstructed defecation, and sexual dysfunction. Pelvic<br>Organ Prolapse (POP) is the hidden epidemic. In the USA it has been conservatively estimated that the prevalence of<br>symptomatic POP will increase by 46% to reach 4.9 million women by 2050. POP is a major public health issue that<br>will continue to grow in developed countries due to the aging populations.<br>Prolapse development is multifactorial, with vaginal child birth, advancing age, and increasing body-mass index<br>as the most consistent risk factors.<br>The integrated lifespan model presented by De Lancey describes predisposing and inciting causal factors for the<br>development of POP where childbirth is considered an important inciting factor.<br>Patients generally present with several complaints, including bladder, bowel, and pelvic symptoms; however,<br>with the exception of vaginal bulging, none is specific to prolapse.<br>Women with symptoms suggestive of prolapse should undergo a pelvic examination. Physical exam (PE)<br>remains the primary modality to evaluate POP, but clinical examination alone is not enough diagnosing pelvic floor<br>dysfunction. The International Continence Society Pelvic Organ Prolapse Quantification (ICS POP-Q) system<br>provides information on surface anatomy only and gives no information on underlying organs or functional anatomy.<br>It can lead to underestimate or misdiagnose the site, degree, and nature of visceral prolapse of pelvic organ prolapse<br>in 45–90% of patients and caused result in incorrect treatment and recurrence of symptoms in 10–30% of patients<br>after surgery.<br>The diagnosis of prolapse of the posterior vaginal compartment, which gynecologists call posterior vaginal wall<br>descent a ‘rectocele’, this appearance may be caused by at least five distinct anatomical conditions which are difficult<br>to distinguish without imaging. These include true radiological rectocele, perineal hypermobility, enterocele,<br>rectoenterocele, and rectal intussusception. Imaging can identify conditions that mimic cystocele, such as urethral<br>diverticula or Gartner cysts, and also can show two types of cystoceles with different functional implications.<br>Therefore, we are needed additional diagnostic tools to make qualified decisions on conservative or surgical<br>treatment. Transperineal sonography is the least invasive, cheapest, simplest, and most commonly available method<br>for pelvic floor imaging. In addition, it has tremendous potential to be used as a research tool in trying to understand<br>the pathophysiology of POP.<br>Childbirth is significantly associated with develop by urinary incontinence(UI) and POP. Levator avulsion is<br>the traumatic disconnection of the puborectalis component of the levator ani from the os pubis. Levator avulsion<br>injury may occur during vaginal delivery, and forceps delivery carries a higher risk of trauma to the pelvic floor<br>muscles than vacuum and normal vaginal delivery. Childbirth-related morphological abnormalities or defects of the<br>puborectalis muscle (“avulsion”) can be diagnosed not only by three-dimensional (3D) ultrasound but by<br>2D translabial ultrasound too. Enlarges the levator hiatus (LH), levator-urethra gap (LUG) as measured by<br>3-dimensional transperineal tomographic ultrasound are also associated with development of POP.<br>Thus, transperineal ultrasound is one of the most reliable and effective methods for diagnosing pelvic floor<br>injuries and dysfunction.</p> ER -