Transperineal Real-time Three-dimensional Ultrasonography In The Treatment Of Patients With Anterior Pelvic Prolapse

Objective To explore the value of quantitative analysis and evaluation of three kinds of operation methods by perineal real-time three-dimensional ultrasound on the postoperative efficacy of patients with anterior pelvic organ prolapse.Methods Divided 153 patients suffered anterior pelvic organ prolapse into 3 groups according to the different surgical procedure,those are modified laparoscopic paravaginal repair(group A,n=28),simple modified anterior pelvic floor reconstruction(group B,n=49),modified anterior pelvic floor reconstruction and sacrospinous ligament suspension(group C,n=76).Transperineal real-time three-dimensional ultrasound examination was performed before and 1,3 and 6 months after operation for the three groups of subjects respectively.bladder neck-symphyseal distance(BSD),bladder neck distance(BND),Urethra rotation angle(URA)and area of the levator hiatus(ALH)before and after operation were measured and compared.The recurrence rates of the three groups were compared.Results The overall differences of BSD,BND,URA and ALH before and after operation were statistically significant(P < 0.001,Tables 1-3).In group a,group b and group c,there were statistically significant differences in each index after operation compared with that before operation(p < 0.008).Compared with 3 months after operation and 6months after operation,the differences of 4 indexes in group a were statistically significant(p < 0.008);The difference of BND and URA in group B was statistically significant(P < 0.008).Only BND difference in group C was statistically significant(P=0.005).At 6 months after operation,the recurrence rate in group C was lower than that in groups A and B(P=0.001 and 0.034).Conclusion Modified anterior pelvic floor reconstruction and sacrospinous ligament suspension is an operation method with better stability and low recurrence rate.Real-time three-dimensional ultrasound can quantitatively evaluate the curative effect of anterior pelvic floor surgery and is worthy of clinical promotion.