OP14.03: Assessment of levator ani using shear wave elastography in postmenopausal women with pelvic organ prolapse

To explore whether shear wave elastography (SWE) can quantitatively evaluate levator ani elastic properties and contractility in postmenopausal women with pelvic organ prolapse (POP), and whether they are different in different POP stages. The patients included 40 unselected postmenopausal women with POP (stages 0-III) were divided into POP 0, POP I, POP II or POP III groups; each group consisted of 10 participants. Pelvic organ prolapse quantitation (POP-Q) was performed for each woman and subsequently POP was diagnosed. The levator hiatus was imaged by transperineal three-dimensional ultrasound to exclude levator ani defect with a volume probe with a frequency of 5–9 MHz. The elastic properties (shear modulus) of the left and the right levator ani muscle belly were measured respectively by SWE at rest and during the maximal contraction manoeuvre with an abdominal probe with a frequency of 2–8 MHz, and the change of shear modulus between at rest and during the maximal contraction was calculated. The shear modulus of the left levator ani muscle or right levator ani muscle were increased gradually at rest, while changes from rest to the maximal contraction were decreased from group POP 0 to POP III (p < 0.05). SWE may be an effective tool for quantitatively assessing the elastic properties and contractility of levator ani with no defect in postmenopausal POP. The levator ani was stiffer in women with POP than for those without or moderate POP.