The effect of pessary treatment on puborectalis muscle function

Manzini, Claudia; Noort, Frieda van den; Grob, Anique T. M.; Withagen, Mariëlla I. J.; Vaart, C. H. van der

doi:10.1007/s00192-021-04766-2

Cited by 5 publications

(5 citation statements)

References 29 publications

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“…They further proposed that vaginal pessaries might reduce the need for continuous contraction to support POP, which would allow the PRM to relax. It was unclear whether the observed changes could really be interpreted as a regain of PRM function 17 . These reports suggest that continuous conservative treatment of POP may prevent progression of pelvic organ descent.…”

Section: Discussionmentioning

confidence: 98%

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Magnetic resonance imaging evaluation of the effectiveness of FemiCushion in pelvic organ prolapse

Nomura

Okada

Nakagawa

et al. 2022

J of Obstet and Gynaecol

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Aims FemiCushion (FC) is a supportive device for pelvic organ prolapse (POP), but its effectiveness has not been evaluated with imaging studies. This study utilized magnetic resonance imaging (MRI) to evaluate the anatomic changes induced by FC use in patients with severe POP. Methods This prospective study examined patients with stage 3 or 4 POP who underwent treatment with FC and received a diagnostic MRI. Measurements were made in the midsagittal plane at rest and during straining with and without FC. The vertical distances from the lowest points of the anterior and posterior vaginal wall (A; P), uterine cervix or vaginal stump (C), and perineal body (PB) to the Pelvic Inclination Correction System line were measured, along with the lengths of the urogenital (UGH) and levator hiatus (LH). Results Twelve patients were included in the study. The median age was 72 (range, 56–84) years. All reference points were positioned significantly higher with the FC than without the FC (median ΔA: 11 mm, p = 0.005; ΔC: 14 mm, p = 0.011; ΔP: 6 mm, p = 0.008; ΔPB: 7 mm, p = 0.002). Median UGH and LH lengths during straining were significantly shorter with the FC than without the FC (UGH: 44 mm vs. 53 mm, p = 0.002; LH: 60 vs. 65 mm, p = 0.021). Conclusions This is the first report on the use of MRI to measure the performance of FC. Our study demonstrates that FC effectively repositioned the organs involved in POP.

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Section: Discussionmentioning

confidence: 98%

“…It was unclear whether the observed changes could really be interpreted as a regain of PRM function. 17 These reports suggest that continuous conservative treatment of POP may prevent progression of pelvic organ descent.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging evaluation of the effectiveness of FemiCushion in pelvic organ prolapse

Nomura

Okada

Nakagawa

et al. 2022

J of Obstet and Gynaecol

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“…The ultrasound scans used in this study were selected and segmented for analysis in two previous clinical studies 15 , 16 . The UH was segmented manually by one observer (C.M.)…”

Section: Methodsmentioning

confidence: 99%

Automatic identification and segmentation of slice of minimal hiatal dimensions in transperineal ultrasound volumes

Noort

Manzini

Vaart

et al. 2022

Ultrasound in Obstet & Gyne

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Objective To develop and validate a tool for automatic selection of the slice of minimal hiatal dimensions (SMHD) and segmentation of the urogenital hiatus (UH) in transperineal ultrasound (TPUS) volumes. Methods Manual selection of the SMHD and segmentation of the UH was performed in TPUS volumes of 116 women with symptomatic pelvic organ prolapse (POP). These data were used to train two deep‐learning algorithms. The first algorithm was trained to provide an estimation of the position of the SMHD. Based on this estimation, a slice was selected and fed into the second algorithm, which performed automatic segmentation of the UH. From this segmentation, measurements of the UH area (UHA), anteroposterior diameter (APD) and coronal diameter (CD) were computed automatically. The mean absolute distance between manually and automatically selected SMHD, the overlap (dice similarity index (DSI)) between manual and automatic UH segmentation and the intraclass correlation coefficient (ICC) between manual and automatic UH measurements were assessed on a test set of 30 TPUS volumes. Results The mean absolute distance between manually and automatically selected SMHD was 0.20 cm. All DSI values between manual and automatic UH segmentations were above 0.85. The ICC values between manual and automatic UH measurements were 0.94 (95% CI, 0.87–0.97) for UHA, 0.92 (95% CI, 0.78–0.97) for APD and 0.82 (95% CI, 0.66–0.91) for CD, demonstrating excellent agreement. Conclusions Our deep‐learning algorithms allowed reliable automatic selection of the SMHD and UH segmentation in TPUS volumes of women with symptomatic POP. These algorithms can be implemented in the software of TPUS machines, thus reducing clinical analysis time and simplifying the examination of TPUS data for research and clinical purposes. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

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“…The etiological factors of pelvic floor dysfunction development include combinations of genetic, anatomical, physiological factors, high parity, and lifestyle factors that interact with each other in different periods of a woman's life and lead to the occurrence of this pathology [19][20][21].…”

Section: Etiology and Pathogenesis Of The Pathology Of Pelvic Organ S...mentioning

confidence: 99%

Diagnostic Value of Dynamic Magnetic Resonance Imaging (dMRI) of the Pelvic Floor in Genital Prolapses

Gilyadova,

Ishchenko,

Puchkova

et al. 2023

Biomedicines

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Pelvic organ prolapse is a chronic disease resulting from a weakening of the musculoskeletal apparatus of the pelvic organs. For the diagnosis of this pathology, it is insufficient to conduct only a clinical examination. An effective diagnostic tool is the method of dynamic magnetic resonance imaging (MRI) of the pelvic floor, which allows a comprehensive assessment of the anatomical and functional characteristics of the walls of the pelvis and pelvic organs. The aim of the study was to analyze the literature data on the possibilities and limitations of using dynamic MRI in pelvic organ prolapse. The widespread use of the dynamic MRI method is due to the high quality of the resulting image, good reproducibility, and the maximum ability to display the characteristics of the pelvic floor. Dynamic MRI of the small pelvis allows a comprehensive assessment of the anatomical and functional features of the pelvis, excluding the effect of ionizing radiation on the body. The method is characterized by good visualization with high resolution and excellent soft tissue contrast. The method allows for assessing the state of the evacuation function of visualized structures in dynamics. Simultaneous imaging of all three parts of the pelvic floor using dynamic MRI makes it possible to assess multicompartment disorders. The anatomical characteristics of the state of the pelvic organs in the norm and in the event of prolapse are considered. The technique for performing the method and the procedure for analyzing the resulting images are described. The possibilities of diagnosing a multicomponent lesion are considered, while it is noted that dynamic MRI of the pelvic organs provides visualization and functional analysis of all three parts of the pelvis and often allows the choice and correction of tactics for the surgical treatment of pelvic organ prolapse. It is noted that dynamic MRI is characterized by a high resolution of the obtained images, and the advantage of the method is the ability to detect functional changes accompanying the pathology of the pelvic floor.

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The effect of pessary treatment on puborectalis muscle function

Cited by 5 publications

References 29 publications

Magnetic resonance imaging evaluation of the effectiveness of FemiCushion in pelvic organ prolapse

Magnetic resonance imaging evaluation of the effectiveness of FemiCushion in pelvic organ prolapse

Automatic identification and segmentation of slice of minimal hiatal dimensions in transperineal ultrasound volumes

Diagnostic Value of Dynamic Magnetic Resonance Imaging (dMRI) of the Pelvic Floor in Genital Prolapses

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