KHẢO SÁT MỐI TƯƠNG QUAN GIỮA KÍCH THƯỚC KHE NIỆU DỤC VÀ KHE CƠ NÂNG VỚI MỨC ĐỘ SA CÁC CƠ QUAN VÙNG CHẬU TRÊN CỘNG HƯỞNG TỪ ĐỘNG HỌC SÀN CHẬU

Abstract

Purpose: To investigate the correlation between the size of the genital hiatus (UGH) and the levator hiatus (LH) with the degree of pelvic organs prolapse on dynamic pelvic floor magnetic resonance imaging.Material and methods: A cross-sectional descriptive study on 52 female patients with clinical pelvic floor dysfunction, who underwent dynamic pelvic floor magnetic resonance imaging and was diagnosed the pelvic organ prolapse at Hanoi Medical University Hospital from 10/2021. Pelvic organ prolapse was based on the distance of the visceral landmarks to the pubococcygeal line (PCL) on MRI at evacuation and is classified into 3 degrees from 0 to 3, corresponding to from no prolapse to severe prolapse. Visceral landmarks include the cervix (or vaginal vault), bladder neck, and the anorectal junction (ARJ). The size of the urogenital hiatus (UGH) was measured from the posterior border of the pubic bone to the posterior vaginal wall. The levator hiatus (LH) size was measured from the posterior border of the pubic bone to the posterior wall of the rectum at the ARJ. Calculate the mean ± deviation of pelvic organ prolapse, of the urogenital hiatus and the levator hiatus at evacuation phase. Investigate the correlation between the size of the urogenital hiatus, the levator hiatus, and the degree of prolapse of the pelvic organs based on the Pearson test. Results: The mean age was 61.1±14.3. Percentage of patients with menopause was 76.9%. History of vaginal birth taked into account for 92.3% of patients. The birth rate of 2 or more children is 90.4%. There are 4/52 patients with a history of hysterectomy, accounting for 7.7%. The average distance between the cervix (or vaginal vault), the ARJ, the bladder neck and the PCL at evacuation phase was 33.2±20 mm, 47±9.5 mm and 31±23.7 mm, respectively. The mean sizes of the urogenital hiatus and the levator hiatus were 50.7±10 mm and 80.2±9.9 mm, respectively. Pearson test showed that there was a correlation between the size of the urogenital hiatus with the degree of bladder prolapse, genital prolapse, and rectal prolapse, respectively with r=0.41, 0.36 and 0.45 (p<0.05). The correlation between the levator hiatus size and the degree of bladder prolapse, genital prolapse and rectal prolapse was with r=0.15, 0.24 (p>0.05), and 0.53 (p<0.05), respectively. Conclusion: Dynamic pelvic floor magnetic resonance imaging showed that the size of the urogenital hiatus was correlated with the degree of prolapse of all 3 pelvic organs. However, the size of the levator hiatus was only correlated with the degree of rectal prolapse but without any correlation with bladder prolapse or uterine prolapse (p>0.05).