The Evaluation Value of Three-dimensional Perineal Ultrasound Combined with Shear Wave Elastography in the Rehabilitation Treatment of Female Stress Urinary Incontinence
WANG Rongrong, HUANG Lizhen, KANG Yaning, et al
Department of Ultrasound, Xi'an Hospital of Traditional Chinese Medicine, Xi'an Shaanxi 710016
Abstract 【Objective】To explore the evaluation value of transperineal pelvic floor ultrasound combined with shear wave elastography in the rehabilitation treatment of female stress urinary incontinence(SUI). 【Methods】A total of 70 female SUI patients treated at the Xi'an Hospital of Traditional Chinese Medicine from January 2021 to November 2021 were selected. All patients were treated with thermosensitive moxibustion combined with Kegel training. Clinical scale scores and pelvic floor ultrasound imaging were performed before and 8 weeks after treatment. The bladder urethra posterior(PUVA), levator ani muscle hiatus area(LHA), levator ani muscle hiatus diameter(LHD), and bladder neck movement(BND) were measured under resting state and Valsalva action,The thickness and mean Young's modulus(Emean) of bilateral puborectal muscles were measured using shear wave elastography in both resting and maximum anal contraction states.【Results】The overall effective rate of SUI patients after 8 weeks of thermal moxibustion combined with Kegel exercise treatment was 88.57%(62/70); Compared with before treatment, SUI patients showed a decrease in the Short Form Urinary Incontinence Questionnaire(ICIQ-SF) score after treatment(P<0.05), as well as a decrease in the frequency of 24-hour urinary incontinence and 1-hour urine leakage(P<0.05). In the resting state, the PUVA, LHD, and LHA of SUI patients decreased significantly after treatment compared to before treatment(P<0.05); Under Valsalva maneuver, SUI patients showed a statistically significant decrease in PUVA, BND, LHD, and LHA after treatment compared to before treatment(P<0.05). There was no statistically significant difference in the thickness of bilateral puborectal muscles between SUI patients before and after treatment in both resting and maximum anal contraction states(P>0.05); After treatment, the bilateral puborectal muscle Emean of SUI patients increased compared to before treatment, and the difference was statistically significant(P<0.05). The difference in ICIQ-SF score before and after treatment was positively correlated with the difference in PUVA score before and after treatment(r=0.67, P<0.05). The difference in ICIQ-SF score before and after treatment was negatively correlated with the difference in bilateral puborectal muscle Emean under maximum anal contraction state(r=-0.58, -0.61, P<0.05). 【Conclusion】Perineal pelvic floor ultrasound combined with elastography can dynamically and quantitatively evaluate the therapeutic effect of female SUI thermal moxibustion combined with Kegel training, providing objective and reliable basis for clinical efficacy evaluation of traditional Chinese medicine.
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2024, Vol. 41 
