Diagnostic value of pelvic floor ultrasonography in female postpartum cystocele

Abstract

Objective To evaluate the diagnostic value of pelvic ultrasonography in female patients with postpartum bladder prolapse. Methods A total of 94 cases of postpartum females with cystocele were enrolled in the study group. And 35 postpartum asymptomatic subjects excluding cystocele by clinical and ultrasound examination were selected as the control group. Transperineal two-dimensional and real-time three-dimensional ultrasound was performed in two groups, and the bladder neck descent (BND) and the area of levator hiatus in Valsalva maneuver were measured, respectively. The BND and the area of levator hiatus were compared between the two groups, and ROC curve were used to assess the value of ultrasound in diagnosis of cystocele. Results The BND and the area of levator hiatus in Valsalva maneuver were (26.2±6.5) mm and (25.2±6.7) cm2 respectively in the study group, which were significantly higher than those in the control group (9.9±4.7) mm and (15.6±3.9) cm2. There were significant differences in BND and area of levator hiatus between the two groups (t=13.56, 7.92, both P<0.05). The cut-off value of the BND and the area of levator hiatus in diagnosis of cystocele were 16 mm and 17.9 cm2 in Valsalva maneuver, respectively. The area under the curve were 0.982 and 0.905, while the sensitivity and specificity were 98.9%, 88.6%, 88.3%, 80.0%, respectively. Conclusion The BND and the area of levator hiatus can be used as the imaging index to diagnose female postpartum cystocele in Valsalva maneuver with high diagnostic value. Key words: Pelvic floor; Ultrasonography; Neck of bladder; Levator ani muscles; Cystocele; Postpartum