Evaluation of acupuncture treatments of postpartum female pelvic floor dysfunction by four-dimensional transperineal pelvic floor ultrasound

Abstract

Introduction: In the present investigation, a systematic evaluation of the clinical treatment performance of diagnosed with pelvic floor dysfunction is explored. By comparing the 4Dtransperineal pelvic floor ultrasound images with the acupuncture treatment performance of the patients, an evaluation system with various parameters is established to provide critical information to guide the clinical treatment fpostpartum female pelvic floor dysfunction (FPFD).

Methods: Eighty patients diagnosed with FPFD are divided into 2 groups. After the designated treatment to the patients, they are carefully examined using transperineal pelvic floor ultrasound. The shape and activity of bladder neck, cervix and rectum anal canal under resting, anal sphincter and Valsalva movements are observed and recorded. The morphology and continuous shape of levator ani muscle in different states after 4D image reconstruction are obtained.

Results: After the acupuncture treatment, the bladder neck descent is decreased by 3.8 cm and the anal levator muscle area is decreased by 3.4 cm2 comparing with the control group. The anal levator muscle hole diameter is decreased by 0.3 cm, while the anterior and posterior diameter is reduced by 0.5 cm. Reduced possibility of cystocele and uterine prolapse is demonstrated by X2 test. These changes upon acupuncture therapy are in line with the improved conditions of the patients, indicating these parameters can help evaluate the therapy performance.

Conclusion: 4D pelvic floor ultrasound imaging provides objective and quantified information for the clinical diagnosis and treatment of FPFD and the assessment of therapy efficacy, making it a promising novel method in practical applications.

Figure 1

Ultrasonic image taken in resting state. ^∗ Represents that there is a significant difference in the decrease of group B compared with group A (P < .05). Number 1 represents draw a horizontal line through the lower edge of the pubic symphysis in a resting state. Number 2 to 4 represent the distance measurements from the lowest point of the bladder neck (number 2), the lowest edge of the cervix (number 3), and the lowest point of the rectal ampulla (number 4).

Figure 2

Ultrasonic image taken in the state of Valsalva maneuver.

Figure 3

Ultrasonic image taken in resting state. ^∗ Represents that there is a significant difference in the decrease of group B compared with group A (P < .05). Schematic diagram of the measurement of the area for the levator ani hiatus (number 1), left and right diameters (number 2), and anteroposterior diameters (number 3) in the resting state (all measured values are normal).

Figure 4

Ultrasonic image taken in the state of Valsalva maneuver. ^∗ Represents that there is a significant difference in the decrease of group B compared with group A (P < .05). Schematic diagram of measurement for levator ani hiatus area (number 1), left and right diameter (number 2), and anteroposterior diameter (number 3) under Valsalva action state (each measured value increases).