The repeatability of sonographic measures of functional pelvic floor anatomy

Li Tan, Ka Lai Shek, Ixora Kamisan @ Atan, Rodrigo Guzman Rojas, Hans Peter Dietz

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Introduction and hypothesis: Translabial 3D/4D ultrasound is increasingly being used in the diagnostic evaluation of pelvic floor dysfunction. The result of the assessment is influenced by a number of confounders that are generally unrecognised. The aim of this study was to determine the short- to medium-term repeatability of translabial ultrasound measures of female pelvic organ support and pelvic floor anatomy. Methods: This is a retrospective study analyzing archived ultrasound volume datasets of 106 patients with pelvic floor dysfunction. Every subject was assessed twice at an average interval of 73 days. Outcome measures including hiatal area on Valsalva, descent of the bladder neck, bladder, uterus and rectal ampulla, rectocele depth, diagnosis of true rectocele, and levator integrity (avulsion) were compared at the first and second appointments. Results: All parameters of organ descent demonstrated good to excellent reliability (ICC 0.73–0.93) except for rectocele descent, which showed moderate reliability (ICC 0.44, CI 0.26–0.58). The most highly repeatable measure was hiatal area on Valsalva or “ballooning” (ICC 0.93, CI 0.90–0.95). For the diagnosis of levator avulsion and true rectocele, agreement was very high (kappa 0.91 for avulsion (CI 0.77–0.94) and kappa 0.73 (CI 0.56–0.84) for true rectocele). Conclusions: The short- to medium-term repeatability of translabial ultrasound measures of functional pelvic floor anatomy seems to be high. Hiatal area on Valsalva (ballooning) and diagnosis of levator avulsion were the most repeatable measures. The least repeatable measures related to the posterior compartment.

Original languageEnglish
Pages (from-to)1667-1672
Number of pages6
JournalInternational Urogynecology Journal and Pelvic Floor Dysfunction
Volume26
Issue number11
DOIs
Publication statusPublished - 14 Jun 2015
Externally publishedYes

Fingerprint

Rectocele
Pelvic Floor
Anatomy
Urinary Bladder
Uterus
Appointments and Schedules
Retrospective Studies
Outcome Assessment (Health Care)

Keywords

  • Female pelvic organ prolapse
  • Levator avulsion
  • Pelvic floor
  • Repeatability
  • Translabial ultrasound

ASJC Scopus subject areas

  • Urology
  • Obstetrics and Gynaecology

Cite this

The repeatability of sonographic measures of functional pelvic floor anatomy. / Tan, Li; Shek, Ka Lai; Kamisan @ Atan, Ixora; Rojas, Rodrigo Guzman; Dietz, Hans Peter.

In: International Urogynecology Journal and Pelvic Floor Dysfunction, Vol. 26, No. 11, 14.06.2015, p. 1667-1672.

Research output: Contribution to journalArticle

Tan, Li ; Shek, Ka Lai ; Kamisan @ Atan, Ixora ; Rojas, Rodrigo Guzman ; Dietz, Hans Peter. / The repeatability of sonographic measures of functional pelvic floor anatomy. In: International Urogynecology Journal and Pelvic Floor Dysfunction. 2015 ; Vol. 26, No. 11. pp. 1667-1672.
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abstract = "Introduction and hypothesis: Translabial 3D/4D ultrasound is increasingly being used in the diagnostic evaluation of pelvic floor dysfunction. The result of the assessment is influenced by a number of confounders that are generally unrecognised. The aim of this study was to determine the short- to medium-term repeatability of translabial ultrasound measures of female pelvic organ support and pelvic floor anatomy. Methods: This is a retrospective study analyzing archived ultrasound volume datasets of 106 patients with pelvic floor dysfunction. Every subject was assessed twice at an average interval of 73 days. Outcome measures including hiatal area on Valsalva, descent of the bladder neck, bladder, uterus and rectal ampulla, rectocele depth, diagnosis of true rectocele, and levator integrity (avulsion) were compared at the first and second appointments. Results: All parameters of organ descent demonstrated good to excellent reliability (ICC 0.73–0.93) except for rectocele descent, which showed moderate reliability (ICC 0.44, CI 0.26–0.58). The most highly repeatable measure was hiatal area on Valsalva or “ballooning” (ICC 0.93, CI 0.90–0.95). For the diagnosis of levator avulsion and true rectocele, agreement was very high (kappa 0.91 for avulsion (CI 0.77–0.94) and kappa 0.73 (CI 0.56–0.84) for true rectocele). Conclusions: The short- to medium-term repeatability of translabial ultrasound measures of functional pelvic floor anatomy seems to be high. Hiatal area on Valsalva (ballooning) and diagnosis of levator avulsion were the most repeatable measures. The least repeatable measures related to the posterior compartment.",
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