Tridimensional Pelvic Floor Ultrasound and Quality of Life Scores Questionnaires in Nulliparous or Parous Women
Condition: Urinary Incontinence; Anal Incontinence; Sexual Dysfunction; Self Esteem; Delivery
MeSH terms: Fecal Incontinence; Urinary Incontinence
Study type: Observational

Summary: 
      Evaluation of the impact of the delivery in the system of suspension and sustentation of
      pelvic floor, by 3D ultrasound and quality of life questionnaires.nt
    

Detailed description: 
      The pelvic floor is a complex group of muscle, fascia and connective tissue that recover the
      basis of the pelvic bones, forming the system of suspension and sustentation of the pelvic
      organs. Different events that happen during the life of women, like pregnancy, delivery, gain
      of weight and hormonal alterations from the menopause, may affects the strength of the
      muscles and of other structures that supports pelvic organs. The importance of the balance of
      the pelvic organs in maintenance of quality of life have been recognized in literature last
      years. Different studies established association between sexual disfunction and emotional
      dissatisfaction, as well as reduction of well-being in that women. The urinary incontinence
      and anal incontinence are also important factors that compromised quality of life and can
      provoke harmful effects over the self-esteem of women and diminish relationship. The 3D
      ultrasound (3D UD) is a non-invasive method, reproductible, and technically easy of evaluate
      the pelvic floor. Different routes may be used, but the transperineal is the most common. By
      this route is possible to evaluate the pelvic floor anatomy, as well as its disfunction into
      deep planes, what we can not afford only with the physical exam.

      The objective was to evaluate the impact of the delivery on the pelvic floor, by the 3D
      ultrasound evaluation and to correlate it with the scores of sexual questionnaire (FSFI),
      urinary questionnaire (King´s) and anal incontinence questionnaire ( specific questions about
      loss of gases).

      This is a transversal study of a cohort of women in reproductive age recruited from May 2016
      to June 2018. The clinical and US evaluation were performed at the same medical visit.
      Patients signed the consent term and answered the questionnaires (King's health quality of
      life questionnaire, FSF-I (Female Sexual Function - Index, and a scale of anal incontinence)
      before the ultrasonographic exams. The USG evaluation was performed using GE Voluson 730
      expert systems with RAB 8- 4 Mhz volume transducers with an 85-degree acquisition angle. The
      exams were performed with patient in supine position with hip flexed and using slightly
      abduced, after voiding. The US transducer was placed on the perineum in the midsagittal
      position and volumes were obtained at rest, at maximum Valsalva, and perineal contraction.
      The volumes datasets were analyzed offline by of the authors. They were blinded and the
      average values were considered.

      The studied parameters was the hiatal area (HA), the antero-posterior diameter (PA),
      transverse diameter (TD) and the muscle thickness (MT). The measures were obtained by the
      OmniView VCI mode.

      Statistical analysis was performed using student t, ANOVA and Tukey. P value of <0.05 was
      considered statistically significant.
    

Intervention name(s): 3D pelvic ultrasound
Intervention type(s): Diagnostic Test
Intervention description(s): 3D pelvic ultrasound by transperineal route
Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Reproductive age women, followed in Family Planning Service and Urogynecology Service of
        Federal of São Paulo University recruited from May 2016 to June 2018.
      
Keywords: 3D ultrasound; pelvic floor; delivery; quality of life