Three-dimensional ultrasound evaluation of the pelvic floor in postmenopausal women using hormone therapy

Delmanto, Lúcia Regina Marques Gomes; Omodei, Michelle Sako; Bueloni-Dias, Flávia Neves; Pontes, Ana Gabriela; Delmanto, Armando; Dias, D.S.; Nahás, Eliana Aguiar Petri

doi:10.1016/j.maturitas.2020.08.009

Cited by 5 publications

(3 citation statements)

References 27 publications

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“…Although, in rats, the Pcm myofiber CSA seems more responsive to estrogens that induce a CSA reduction 27,28 . Overall, we believe these findings shed light on the understanding of menopausal hormone therapy on PFM morphometry 29 …”

Section: Discussionmentioning

confidence: 62%

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Estrogens influence differentially on the pelvic floor muscles activation at somatovisceral reflexes involved in micturition of rabbits

et al. 2021

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Objective: To determine the estrogen-dependency of the bladder and urethral function and the coordinated activation of pelvic floor muscles (PFM) during micturition.Methods: We allocated age-matched female rabbits to control, 1-month ovariectomized (OVX), and OVX plus 2-week estradiol benzoate (EB) groups to record cystometry, urethral pressure, and electromyograms of bulbospongiosus (Bsm), and pubococcygeus muscles (Pcm) simultaneously. We also measured serum estradiol levels and myofiber cross-sectional area. We assessed urodynamic and urethral variables, categorized the Bsm-Pcm activation patterns at storage and voiding phases, and obtained the power spectrum density of muscle activation around the voiding phase. We investigated the influence of ovarian hormones, in general, and the contribution of estrogen, particularly on the functions of the bladder, urethra, and PFM. Statistical significance was set at P < 0.05.Results: Ovarian hormones influence the bladder, urethral, and PFM functions. The urodynamics analyses indicated estrogens contribute to voiding duration and, to a lesser extent, to the time between bladder contractions. Urethral pressure at closure (maximal pressure-to-maximal urethral pressure ratio) improved partially (8%, P < 0.05) in the OVX plus 2-week estradiol benzoate compared with OVX, but urethral resistance increased ($1.9-fold, P < 0.05) compared with control rabbits. Our findings support that Pcm activity at voiding is estrogensensitive, albeit EB administration reduced it at storage resume, which relates to high urethral resistance.Conclusions: Ovariectomy impairs bladder and urethral pressures and Bsm and Pcm activation at micturition in anesthetized rabbits. Estrogen administration partially reverts some of these effects and influences Pcm activation.

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Section: Discussionmentioning

confidence: 62%

“…27,28 Overall, we believe these findings shed light on the understanding of menopausal hormone therapy on PFM morphometry. 29 Reduced estradiol levels undermine bladder contractility in rabbits. [18][19][20] Estradiol (7-d) reverses the mild atrophy of smooth muscle and contractile responses measured 7 days after ovariectomy.…”

Section: Discussionmentioning

confidence: 99%

Estrogens influence differentially on the pelvic floor muscles activation at somatovisceral reflexes involved in micturition of rabbits

et al. 2021

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“…Three-dimensional (3D) ultrasound, a frequently adopted imaging examination method, can clearly present the pelvic floor tissue and its internal organs, so it is a preferred examination method for obstetrical and gynecological diseases. 7 In the present study, PFD in postpartum women was assessed by 3D ultrasound of the pelvic floor, and factors affecting its incidence were analyzed, so as to provide a reference for early prophylaxis of PFD in women. 4) those who and whose family members signed the informed consent.…”

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confidence: 99%

Diagnostic value of combined pelvic floor ultrasound parameters for pelvic floor dysfunction and risk factors

Cai

Huang

et al. 2022

J of Clinical Ultrasound

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Objective To investigate the diagnostic value of pelvic floor ultrasound parameters in combination for pelvic floor dysfunction (PFD), and to explore the risk factors. Methods Forty PFD patients treated from April2019to December 2020(case group) and another 40 healthy women (control group) were enrolled. Their clinical data were collected, and both groups received three‐dimensional (3D) ultrasound of the pelvic floor. The diagnostic value of pelvic floor ultrasound parameters for PFD was assessed by receiver operating characteristic (ROC) curves. The risk factors of PFD were evaluated by multivariate logistic regression analysis. Results The area under the ROC curve (AUC), sensitivity, and specificity of the parameters in combination for predicting PFD were 0.851 [95% confidence interval (CI): 0.743–0.959], 0.901, and 0.812, respectively, indicating acceptable accuracy. Results of logistic regression analysis revealed that spontaneous delivery, lateral episiotomy/laceration, and large bladder neck rotation angle, posterior urethrovesical angle (PUA), bladder neck tilt angle, bladder neck distance (BND), levator hiatus area (LHA) (at anal contraction), R‐LHA and V‐LHA were risk factors for PFD (p < 0.05), while physical exercise was a protective factor (p < 0.05). ROC curve analysis revealed that the AUC, sensitivity, and specificity of the forest map model were 0.822 (95% CI: 0.759–0.885), 0.942, and 0.601, respectively, indicating acceptable accuracy of the model. Internal data validation of the model demonstrated consistence of the predicted occurrence of PFD with the actual one. Conclusions Spontaneous delivery, lateral episiotomy/laceration, and large bladder neck rotation angle, PUA, bladder neck tilt angle, BND, LHA (at anal contraction), R‐LHA and V‐LHA were risk factors for PFD.

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Stress urinary incontinence and the forgotten female hormones

Siddle¹,

Versi

Robert

2022

Int Urogynecol J

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Three-dimensional ultrasound evaluation of the pelvic floor in postmenopausal women using hormone therapy

Cited by 5 publications

References 27 publications

Estrogens influence differentially on the pelvic floor muscles activation at somatovisceral reflexes involved in micturition of rabbits

Estrogens influence differentially on the pelvic floor muscles activation at somatovisceral reflexes involved in micturition of rabbits

Diagnostic value of combined pelvic floor ultrasound parameters for pelvic floor dysfunction and risk factors

Stress urinary incontinence and the forgotten female hormones

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