Ultrasongraphic age‐related changes of the pelvic floor muscles in nulliparous women and their association with pelvic floor symptoms: A pilot study

Abstract

Objective To assess age‐related changes in the pelvic floor muscular hiatus and their association with symptoms of pelvic organ prolapse, urinary and fecal incontinence, and sexual function. Methods In this pilot study we performed 3D endovaginal ultrasonography in two age groups of nulliparous women: 18 to 40 years and 52 to 85 years. Anterior‐posterior (AP) diameter, left‐right (LR) diameter, and the Minimal Levator Hiatus area were measured. The AP/LR ratio was calculated to compare the shape of the pelvic floor muscles between participants (oval vs circular). Other measurements included length of the urethra, and levator plate lift. Participants were assessed for (1) distress symptoms of pelvic floor prolapse, urinary, and fecal symptoms by the Pelvic Floor Distress Inventory‐20, (2) quality of life via the pelvic floor impact inventory‐7, and (3) sexual function by the female sexual function inventory (FSFI‐19). Results A total of 12 women into the younger group and 10 to the older group were recruited. Older women had higher AP/LR ratio and longer distance levator plate lift while performing the squeeze maneuver ( P = 0.017 and 0.038, respectively). Older women had worse urinary and pelvic organ prolapse symptoms ( P = 0.002 and 0.004, respectively). Fewer women in the older group were sexually active (60% vs 92%) and their quality of sexual life was lower based on their FSFI‐19 results. Conclusion Levator ani muscle hiatus changes to a more oval form in older nulliparous postmenopausal women and this change in shape is associated with increased pelvic floor symptoms.

Prediction of postpartum pelvic floor dysfunction with a nomogram model based on big data collected during pregnancy

“…Risk factors for PFD include pregnancy, childbirth, age, and estrogen levels, among which pregnancy and childbirth are the most important factors (11)(12)(13)(14)(15). Rehabilitation after the occurrence of PFD often does not achieve the most satisfactory effect, and appropriate guidance and close follow-up are indispensable for achieving effective therapy (16,17). Therefore, it is necessary to identify pregnant women with a high risk of PFD in 18), and the 32nd gestational week is one of the time points for routine prenatal check-ups in China.…”

Does aging affect the elastic properties of the bladder and the urethra in nulliparous women: An ultrasound shear‐wave elastography study

“…Various technologies have been used to explore pelvic floor tissue characterizations. For instance, Vaginal Tactile Imager has been used to study the pressure differences in women with POP versus a control group, 16 sonographic characterization of the pelvic floor, and the change following menopause 17 . Ultrasound shear wave elastography (SWE) is an imaging method that quantifies tissue stiffness and elasticity using sound waves.…”

“…For instance, Vaginal Tactile Imager has been used to study the pressure differences in women with POP versus a control group, 16 sonographic characterization of the pelvic floor, and the change following menopause. 17 Ultrasound shear wave elastography (SWE) is an imaging method that quantifies tissue stiffness and elasticity using sound waves. It was described over 30 years ago and has been used to describe elastic properties of different tissues.…”

Reliability of ultrasound imaging of pelvic floor morphology and function among females who have undergone pelvic radiotherapy

“…2D-transperineal ultrasound images have been used for the evaluation of the PFMs at rest and transient changes in the length of the levator plate (LP) seen during a PFM contraction of asymptomatic women, as well as those with stress urinary incontinence and provoked vestibulodynia. [20][21][22][23][24][25][26] 2D USI may be helpful for the study of PFM after pelvic irradiation, yet the reliability of these measures in this population is unknown. Challenges in the reliability of conducting transperineal 2D-USI assessments may exist secondary to the presence of radiation-induced fibrosis in the pelvic floor.…”

“…However, the current use of 3D‐USI in nonobstetrical clinical settings and physiotherapy clinics is limited, and 2D measures remain the most accessible tool in such settings. 2D‐transperineal ultrasound images have been used for the evaluation of the PFMs at rest and transient changes in the length of the levator plate (LP) seen during a PFM contraction of asymptomatic women, as well as those with stress urinary incontinence and provoked vestibulodynia 20–26 …”