Pelvic hiatal area measured by a novel 3D ultrasound technique in women with and without symptoms of pelvic floor dysfunction

Luisa Cariello*, Elisa Montaguti*, Tullio Ghi*, Olimpia Sanlorenzo*, Gianluigi Pilu*, Nicola Rizzo*, Aly Youssef*
* Department of Obstetrics and Gynecology, Sant’Orsola-Malpighi Hospital, University of Bologna, Italy

Objectives: To compare the pelvic hiatal area between women with and without symptoms of pelvic floor dysfunction using a novel validated 3D ultrasound technique: the Omniview-Volume contrast imaging (Omniview-VCI, GE Healthcare).
Methods: We acquired a static 3D ultrasound transperineal volume from 124 nulliparous asymptomatic and 118 women with symptoms of pelvic floor dysfunction at rest. Symptoms included urinary/fecal incontinence in 74 (66.1%) women, pelvic organ prolapse in 46 (40.0%), and dyspareunia in 15 (12.7%). Each 3D dataset was analyzed by means of the Omniview-VCI technique and the 3D rendering method to measure the pelvic hiatal area. Pelvic hiatal area was then compared between symptomatic and asymptomatic women
Results: Women in the symptomatic group were older (23.4±2.7 vs. 45.9±12.8 years, P<0.001), had a higher parity (1.5±0.8 vs. 0.0, P<0.001), and a higher body mass index (21.0±3.0 vs. 25.9±4.1, P<0.001) when compared with asymptomatic women. The pelvic hiatal area was significantly larger in symptomatic women than asymptomatic women when measured both by Omniview-VCI technique (13.18±2.30 vs. 15.85±4.49 cm2, P<0.001) and by 3D rendering method (13.12±2.35 vs. 15.77±4.5 cm2, P<0.001).
Conclusions: Pelvic hiatal area as measured both by the novel Omniview-VCI technique and by the 3D rendering method are significantly larger in women with symptoms of pelvic floor dysfunction pelvic floor dysfunction.

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