Utility of Shear Wave Elastography Combined with Transperineal Pelvic Floor Ultrasound in Evaluating Pelvic Floor Function After Hysterectomy

Xiangqin Tang,1,* Guangqun Wu,2,* Yanxia Xiao,1 Ya Yang,1 Chunmei Xiao,3 Chunyan Zhong3 1Department of Ultrasound, Bishan Maternity & Child Hospital of Chongqing, Chongqing, People’s Republic of China; 2Department of Obstetrics, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guizhou, People’s Republic of China; 3Department of Ultrasound, Chongqing Health Center for Women and Children/Women and Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chunyan Zhong, Department of Ultrasound, Chongqing Health Center for Women and Children/Women and Children’s Hospital of Chongqing Medical University, No. 120, Longshan Road, Yubei District, Chongqing, 400021, People’s Republic of China, Tel +86 023 60354359, Email [email protected]: To study the utility of Shear Wave Elastic (SWE) combined with transperineal ultrasound in evaluating pelvic floor function after hysterectomy.Patients and Methods: Sixty patients who underwent hysterectomy at our hospital between April 2018 and January 2023 were enrolled as the study group, and another 60 volunteers without hysterectomy were selected as the control group. General conditions, Ultrasonic parameters and related factors of pelvic floor dysfunction were collected and compared between the two groups.Results: Ultrasonic diameters, including distance between bladder neck and pubic symphysis, the posterior angle of vesicourethra, the anterior-posterior diameter of levator hiatus and bladder neck mobility, were all different between patients with or without hysterectomy during Valsalva (P < 0.05). For SWE examination, elasticity of left and right levator ani muscle (LAM) at rest, the difference in elasticity of left and right levator ani muscle at rest and during Valsalva were statistically different between the two groups (P< 0.001). The incidence of cystocele and uterine/vault prolapse in study group was significantly higher than control group (P < 0.05). The evaluation efficiency of transperineal ultrasound plus SWE was better than that of transperineal ultrasound only.Conclusion: Pelvic floor dysfunction is more likely to occur in patients with hysterectomy, especially cystocele and uterine/vault prolapse. The decreased elasticity of levator ani muscle may be one of the factors.Keywords: transperineal ultrasound, shear wave elastography, hysterectomy, pelvic floor function