ĐÁNH GIÁ MỐI LIÊN QUAN GIỮA MỨC ĐỘ SA SINH DỤC VỚI KÍCH THƯỚC KHE SINH DỤC TRÊN CỘNG HƯỞNG TỪ ĐỘNG HỌC SÀN CHẬU

Abstract

Purpose: To describe the relationship between the size of the genital hiatus (GH- Genital Hiatus) and the degree of genital prolapse on dynamic pelvic floor magnetic resonance imaging (DP-MRI) in a group of female patients who came to Hanoi Medical University Hospital for pelvic floor dysfunction. Material and methods: a cross-sectional descriptive study on 52 patients with clinical pelvic floor dysfunction, underwent dynamic pelvic floor magnetic resonance imaging and diagnosed genital prolapse at Hanoi Medical University Hospital from 10/2021 to 05/2023. Genital prolapse is classified into 4 degrees on DP- MRI based on the cervical landmark (or vaginal vault) compared with the PCL (grade 0: no prolapse, grade 1: mild prolapse, grade 2: moderate prolapse, grade 3: severe prolapse). Mean ± deviation of cervical prolapse (or vaginal vault) below the PCL and of the genital  hiatus at evacuation phase. Compare the size of the genital hiatus dimension with the degrees of genital prolapse classified on DP-MRI and evaluate the relationship between the two factors based on the Pearson test. Results: The mean age was 61.1±14.3, the highest was 90 y.o and the lowest was 27 y.o. The rate of genital prolapse was most common in the age group 50-80 y.o (accounting for 65.4%). Percentage of patients having menopause was 76.9%. The majority (92.3%) of patients gave birth vaginally. The birth rate of 2 or more children was 90.4%, the birth rate of 3 or more children was 40.4%. There were 4/52 patients with a history of hysterectomy, accounting for 7.7%. The average distance between the cervix (or vaginal vault) below the PCL at evacuation phase was 33.2±20 mm, the lowest was 6 mm, the highest was 90 mm. There were 22 patients with grade 1 prolapse, accounting for 42.3%, there were 23 patients with grade 2 prolapse, accounting for 44.2%, there were 7 patients with grade 3 prolapse, accounting for 13.5%. The average dimension of the genital hiatus was 50.7±10 mm. The dimension of the genital hiatus corresponding to grade 1, 2, 3, and 4 prolapse was 46.8±8.8, 52.8±8.5, 56±14.4 mm, respectively. Pearson test showed that there was a moderate correlation between the size of the genital hiatus and the degree of genital prolapse with r=0.36, p=0.008. There was a statistically significant difference in the size of the genital hiatus between grade 1 and grade 2 genital prolapse (p=0.026) but there was no statistically significant difference between the remaining degrees of genital prolapse. Conclusion: Dynamic Pelvic floor magnetic resonance imaging showed a relatively strong correlation between the size of the genital hiatus and the degree of genital prolapse, thereby helping to choose the treatment method.