Value of Transperineal Ultrasound in Short-term Evaluation of Pelvic Organ Prolapse after Transvaginal Mesh Implantation

Abstract

Objective To observe the patients after transvaginal mesh(TVM)implantation surgery by using transperineal ultrasound(TPUS),compare the diagnosis of pelvic organ prolapse(POP)by TPUS and clinical examination[according to the Pelvic Organ Prolapse Quantification(POP-Q)system published by the International Continence Society],and to explore the role of ultrasound in postoperative evaluation as well as the high-risk factors of post-surgery POP recurrence. Methods This is a retrospective study based on the POP-Q records and TPUS data sets of patients within 6 months after TVM surgery during September 2013 and November 2019.The diagnostic results of TPUS and POP-Q were compared.The incidences of hiatal ballooning and levator avulsion were separately compared between the TPUS group and the control group. Results A total of 147 patients were enrolled.The Kappa values between TPUS and POP-Q in the diagnosis of anterior and posterior compartment POP were 0.268(P=0.000)and 0.235(P=0.001),respectively.There were altogether 37 cases diagnosed inconsistently between TPUS and POP-Q,including 14(9.52%)cases of anterior compartment prolapse and 23(15.65%)cases of posterior compartment prolapse.TPUS diagnosed 32 more cases of prolapse than POP-Q,which included 13(8.84%)cases of anterior compartment prolapse and 19(12.93%)cases of posterior compartment prolapse.The incidence of hiatal ballooning in the TPUS prolapse group was significantly higher than control group(51.35% vs.33.94%,χ2=3.950,P=0.047).The incidence of levator avulsion showed no significant difference between the two groups(P=1.000). Conclusions TPUS diagnosis of POP after TVM surgery has consistency with the POP-Q diagnosis of International Continence Society.TPUS can detect more POP cases,and thus it may act as a supplement for clinical diagnosis.Hiatal ballooning is associated with POP recurrence after TVM surgery.