Impact of Dynamic Transrectal Ultrasonography on Pelvic Organ Prolapse

Ultrasound Quantitative Assessment of the Effects of Yoga on Early Postpartum Pelvic Organ Position Recovery

INTRODUCTION AND HYPOTHESIS

This study examines the effectiveness of yoga intervention on the early postpartum recovery of pelvic organ positions.

METHODS

A prospective study was conducted from May to November 2020, involving women who had vaginal deliveries and underwent pelvic floor ultrasound examinations. The control group received no intervention, whereas the experimental group participated in weekly 60-min yoga sessions from 1 week to 3 months postpartum. Pelvic organ positions, including the bladder neck, uterus, and rectal ampulla, were measured via ultrasound at rest and during the Valsalva maneuver at 42 days and 3 months postpartum. The effectiveness of yoga was assessed using t tests.

RESULTS

A total of 128 women participated, with 66 in the control group and 62 in the experimental group. There were no significant differences between groups in age, parity, BMI, or fetal weight (p > 0.05). At 42 days postpartum, there were no significant changes in bladder neck and uterine positions at rest, except for a significant decrease in rectal ampulla position in the control group (p < 0.01). During the Valsalva maneuver, the experimental group showed significant improvement in all pelvic organ positions at 3 months compared with 42 days (p < 0.001), with better outcomes than the control group (p < 0.001).

CONCLUSION

Yoga intervention supports early postpartum recovery of pelvic organ positions.

Vorticity in lower urinary tract can be assessed and associates with urinary tract morphology in men

OBJECTIVES

The aim of this study is to develop a method to evaluate the fluid dynamics of urine flow in the lower urinary tract (LUT), especially that of vorticity.

MATERIALS AND METHODS

This investigation included three sub-studies to demonstrate urine flow in the entire LUT. First, we attempted to observe vorticity generation in the urinary bladder during spontaneous voiding using transabdominal color Doppler ultrasonography (CDUS). Second, we performed transrectal CDUS to evaluate the vorticity of urine flow in the prostatic urethra. Patients with prostate cancer were enrolled before robotic surgery and divided into the vorticity and non-vorticity groups based on CDUS findings for comparisons of longitudinal urethral diameter and prostatic urethral angle. Third, the vorticity of the voided urine stream was observed using a high-speed video-camera. Micturition was done in a standing position while synchronously monitored for urine flow using uroflowmetry.

RESULTS

Vorticity formation could be dynamically demonstrated in the urinary bladder and prostatic urethra using CDUS. The prostatic urethral angle of the vorticity group was more than that of the non-vorticity group. High-speed video recording could clearly capture vorticity and spiral shape generation in voided urine. The distance from the external urethral orifice to the first twist changed in accordance with urine flow rate.

CONCLUSIONS

In a series of sub-studies, this investigation proved vorticity generation in the LUT and voided urine. Vorticity was detectable in the LUT and in voided urine using CDUS and a high-speed video-camera. Vorticity generation might be associated with urethral morphology.

[Cystocele and perineal ultrasound : Comparison of reliability and patient satisfaction]

BACKGROUND

Pelvic organ prolapse is a common medical finding. The use of perineal ultrasound for diagnosis of cystoceles is gaining in importance.

OBJECTIVES

The purpose of this work was to test whether perineal ultrasound can be used to diagnose a cystocele before surgery and for follow-up examination. Furthermore, patient satisfaction during speculum examination and perineal ultrasound was compared.

MATERIALS AND METHODS

33 women with cystocele were examined before and after anterior colporrhaphy. Symptoms and satisfaction were documented with questionnaires.

RESULTS

Ultrasound measurements of both examiners were correlated before and after colporrhaphy. Also, the degree of cystocele and ultrasound were correlated during Valsalva after surgery. There was no clear relation between typical symptoms of the cystocele and ultrasound measurements. The patient's comfort is higher during ultrasound than during speculum examination (r = 0.45; p = 0.04. t = 4,418; p < 0.01).

CONCLUSION

The results of the perineal ultrasound are reproducible before and after colporrhaphy. Patients prefer ultrasound to the speculum examination. A sonographic scale of the cystocele would extend the use of perineal ultrasound.