Anatomical and functional characteristics of the pelvic floor in nulliparous women submitted to three-dimensional endovaginal ultrasonography : case control study and evaluation of interobserver agreement

Detalhes bibliográficos
Autor(a) principal: Murad-Regadas, Sthela Maria
Data de Publicação: 2013
Outros Autores: Silveira, Claudio Regis Sampaio, Pereira, Jacyara de Jesus Rosa, Fernandes, Graziela Olivia da Silva, Vasconcelos Neto, José Ananias, Dealcanfreitas, Iris Daiana, Bezerra, Leonardo Robson Pinheiro Sobreira
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da Universidade Federal do Ceará (UFC)
Texto Completo: http://www.repositorio.ufc.br/handle/riufc/7676
Resumo: PURPOSE: To determine anatomical and functional pelvic floor measurements performed with three-dimensional (3-D) endovaginal ultrasonography in asymptomatic nulliparous women without dysfunctions detected in previous dynamic 3-D anorectal ultrasonography (echo defecography) and to demonstrate the interobserver reliability of these measurements. METHODS: Asymptomatic nulliparous volunteers were submitted to echo defecography to identify dynamic dysfunctions, including anatomical (rectocele, intussusceptions, entero/sigmoidocele and perineal descent) and functional changes (nonrelaxation or paradoxical contraction of the puborectalis muscle) in the posterior compartment and assessed with regard to the biometric index of levator hiatus, pubovisceral muscle thickness, urethral length, anorectal angle, anorectal junction position and bladder neck position with the 3-D endovaginal ultrasonography. All measurements were compared at rest and during the Valsalva maneuver, and perineal and bladder neck descent was determined. The level of interobserver agreement was evaluated for all measurements. RESULTS: A total of 34 volunteers were assessed by echo defecography and by 3-D endovaginal ultrasonography. Out of these, 20 subjects met the inclusion criteria. The 14 excluded subjects were found to have posterior dynamic dysfunctions. During the Valsalva maneuver, the hiatal area was significantly larger, the urethra was significantly shorter and the anorectal angle was greater. Measurements at rest and during the Valsalva maneuver differed significantly with regard to anorectal junction and bladder neck position. The mean values for normal perineal descent and bladder neck descent were 0.6 cm and 0.5 cm above the symphysis pubis, respectively. The intraclass correlation coefficient ranged from 0.62–0.93. CONCLUSIONS: Functional biometric indexes, normal perineal descent and bladder neck descent values were determined for young asymptomatic nulliparous women with the 3-D endovaginal ultrasonography. The method was found to be reliable to measure pelvic floor structures at rest and during Valsalva, and might therefore be suitable for identifying dysfunctions in symptomatic patients.
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spelling Anatomical and functional characteristics of the pelvic floor in nulliparous women submitted to three-dimensional endovaginal ultrasonography : case control study and evaluation of interobserver agreementPURPOSE: To determine anatomical and functional pelvic floor measurements performed with three-dimensional (3-D) endovaginal ultrasonography in asymptomatic nulliparous women without dysfunctions detected in previous dynamic 3-D anorectal ultrasonography (echo defecography) and to demonstrate the interobserver reliability of these measurements. METHODS: Asymptomatic nulliparous volunteers were submitted to echo defecography to identify dynamic dysfunctions, including anatomical (rectocele, intussusceptions, entero/sigmoidocele and perineal descent) and functional changes (nonrelaxation or paradoxical contraction of the puborectalis muscle) in the posterior compartment and assessed with regard to the biometric index of levator hiatus, pubovisceral muscle thickness, urethral length, anorectal angle, anorectal junction position and bladder neck position with the 3-D endovaginal ultrasonography. All measurements were compared at rest and during the Valsalva maneuver, and perineal and bladder neck descent was determined. The level of interobserver agreement was evaluated for all measurements. RESULTS: A total of 34 volunteers were assessed by echo defecography and by 3-D endovaginal ultrasonography. Out of these, 20 subjects met the inclusion criteria. The 14 excluded subjects were found to have posterior dynamic dysfunctions. During the Valsalva maneuver, the hiatal area was significantly larger, the urethra was significantly shorter and the anorectal angle was greater. Measurements at rest and during the Valsalva maneuver differed significantly with regard to anorectal junction and bladder neck position. The mean values for normal perineal descent and bladder neck descent were 0.6 cm and 0.5 cm above the symphysis pubis, respectively. The intraclass correlation coefficient ranged from 0.62–0.93. CONCLUSIONS: Functional biometric indexes, normal perineal descent and bladder neck descent values were determined for young asymptomatic nulliparous women with the 3-D endovaginal ultrasonography. The method was found to be reliable to measure pelvic floor structures at rest and during Valsalva, and might therefore be suitable for identifying dysfunctions in symptomatic patients.OBJETIVO: Avaliar as medidas anatômicas e funcionais do assoalho pélvico utilizando a ultrassonografia tridimensional transvaginal em nulíparas assintomáticas sem disfunções do compartimento posterior evidenciado pela ecodefecografia. Demonstrar o grau de concordância entre observadores do método utilizado para medir as estruturas anatômicas. MÉTODOS: Voluntárias nulíparas assintomáticas foram submetidas à ecodefecografia para identificar alterações dinâmicas no compartimento posterior, incluindo aquelas anatômicas (retocele, intussuscepção, entero/sigmoidocele e descenso perineal) e funcionais (ausência de relaxamento ou contração paradoxal do puborretal) e avaliadas com ultrassonografia tridimensional transvaginal para determinar índices biométricos do hiato dos elevadores do ânus, espessura do músculo pubovisceral, comprimento da uretra, ângulo anorretal, posição da junção anorretal e posição do colo vesical. Todas as medidas foram comparadas em repouso e durante Valsalva; e determinado descenso perineal e do colo da bexiga. A variabilidade interobservador foi avaliada utilizando o coeficiente de correlação intraclasse. RESULTADOS: Foram avaliadas 34 voluntárias com a ecodefecografia e a ultrassonografia tridimensional transvaginal. Dessas, 20 foram incluídas no estudo. As 14 excluídas apresentavam alterações dinâmicas no compartimento posterior. Durante a manobra de Valsalva, a área hiatal foi significativamente maior. A uretra foi significantemente mais curta e o ângulo anorretal foi maior. Medidas em repouso e durante a Valsalva diferiram significativamente em relação à posição da junção anorretal e do colo vesical. A média de valor do descenso perineal e do descenso da bexiga foram de 0,6 cm e 0,5 cm acima da sínfise púbica, respectivamente. O coeficiente de correlação intraclasse variou entre 0,62–0,93. CONCLUSÕES: Foram determinados valores normais para os índices biométricos funcionais, descida perineal e colo vesical em nulíparas assintomáticas utilizando-se a ultrassonografia transvaginal tridimensional. É um método seguro para mensurar a anatomia do assoalho pélvico durante o repouso e a manobra de Valsalva, e pode ser adequado para a identificação de disfunções em pacientes sintomáticos.Revista Brasileira de Ginecologia e Obstetrícia2014-03-14T13:05:59Z2014-03-14T13:05:59Z2013-03info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfMURAD-REGADAS, Sthela Maria ; BEZERRA, Leonardo Robson Pinheiro Sobreira ; SILVEIRA, Claudio Regis Sampaio ; PEREIRA, Jacyara deJesus Rosa ; FERANDES, Graziela Olivia da Silva ; VASCONCELOS NETO, José Ananias ; DEALCANFREITAS, Iris Daiana. Anatomical and functional characteristics of the pelvic floor in nulliparous women submitted to three-dimensional endovaginal ultrasonography : case control study and evaluation of interobserver agreement. Revista Brasileira de Ginecologia e Obstetrícia (Impresso), Rio de Janeiro-RJ, v. 35, n. 3, p. 123-129, mar. 2013.0100-7203http://www.repositorio.ufc.br/handle/riufc/7676Murad-Regadas, Sthela MariaSilveira, Claudio Regis SampaioPereira, Jacyara de Jesus RosaFernandes, Graziela Olivia da SilvaVasconcelos Neto, José AnaniasDealcanfreitas, Iris DaianaBezerra, Leonardo Robson Pinheiro Sobreiraengreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccess2022-05-13T19:51:17Zoai:repositorio.ufc.br:riufc/7676Repositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2024-09-11T18:57:44.677869Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false
dc.title.none.fl_str_mv Anatomical and functional characteristics of the pelvic floor in nulliparous women submitted to three-dimensional endovaginal ultrasonography : case control study and evaluation of interobserver agreement
title Anatomical and functional characteristics of the pelvic floor in nulliparous women submitted to three-dimensional endovaginal ultrasonography : case control study and evaluation of interobserver agreement
spellingShingle Anatomical and functional characteristics of the pelvic floor in nulliparous women submitted to three-dimensional endovaginal ultrasonography : case control study and evaluation of interobserver agreement
Murad-Regadas, Sthela Maria
title_short Anatomical and functional characteristics of the pelvic floor in nulliparous women submitted to three-dimensional endovaginal ultrasonography : case control study and evaluation of interobserver agreement
title_full Anatomical and functional characteristics of the pelvic floor in nulliparous women submitted to three-dimensional endovaginal ultrasonography : case control study and evaluation of interobserver agreement
title_fullStr Anatomical and functional characteristics of the pelvic floor in nulliparous women submitted to three-dimensional endovaginal ultrasonography : case control study and evaluation of interobserver agreement
title_full_unstemmed Anatomical and functional characteristics of the pelvic floor in nulliparous women submitted to three-dimensional endovaginal ultrasonography : case control study and evaluation of interobserver agreement
title_sort Anatomical and functional characteristics of the pelvic floor in nulliparous women submitted to three-dimensional endovaginal ultrasonography : case control study and evaluation of interobserver agreement
author Murad-Regadas, Sthela Maria
author_facet Murad-Regadas, Sthela Maria
Silveira, Claudio Regis Sampaio
Pereira, Jacyara de Jesus Rosa
Fernandes, Graziela Olivia da Silva
Vasconcelos Neto, José Ananias
Dealcanfreitas, Iris Daiana
Bezerra, Leonardo Robson Pinheiro Sobreira
author_role author
author2 Silveira, Claudio Regis Sampaio
Pereira, Jacyara de Jesus Rosa
Fernandes, Graziela Olivia da Silva
Vasconcelos Neto, José Ananias
Dealcanfreitas, Iris Daiana
Bezerra, Leonardo Robson Pinheiro Sobreira
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Murad-Regadas, Sthela Maria
Silveira, Claudio Regis Sampaio
Pereira, Jacyara de Jesus Rosa
Fernandes, Graziela Olivia da Silva
Vasconcelos Neto, José Ananias
Dealcanfreitas, Iris Daiana
Bezerra, Leonardo Robson Pinheiro Sobreira
description PURPOSE: To determine anatomical and functional pelvic floor measurements performed with three-dimensional (3-D) endovaginal ultrasonography in asymptomatic nulliparous women without dysfunctions detected in previous dynamic 3-D anorectal ultrasonography (echo defecography) and to demonstrate the interobserver reliability of these measurements. METHODS: Asymptomatic nulliparous volunteers were submitted to echo defecography to identify dynamic dysfunctions, including anatomical (rectocele, intussusceptions, entero/sigmoidocele and perineal descent) and functional changes (nonrelaxation or paradoxical contraction of the puborectalis muscle) in the posterior compartment and assessed with regard to the biometric index of levator hiatus, pubovisceral muscle thickness, urethral length, anorectal angle, anorectal junction position and bladder neck position with the 3-D endovaginal ultrasonography. All measurements were compared at rest and during the Valsalva maneuver, and perineal and bladder neck descent was determined. The level of interobserver agreement was evaluated for all measurements. RESULTS: A total of 34 volunteers were assessed by echo defecography and by 3-D endovaginal ultrasonography. Out of these, 20 subjects met the inclusion criteria. The 14 excluded subjects were found to have posterior dynamic dysfunctions. During the Valsalva maneuver, the hiatal area was significantly larger, the urethra was significantly shorter and the anorectal angle was greater. Measurements at rest and during the Valsalva maneuver differed significantly with regard to anorectal junction and bladder neck position. The mean values for normal perineal descent and bladder neck descent were 0.6 cm and 0.5 cm above the symphysis pubis, respectively. The intraclass correlation coefficient ranged from 0.62–0.93. CONCLUSIONS: Functional biometric indexes, normal perineal descent and bladder neck descent values were determined for young asymptomatic nulliparous women with the 3-D endovaginal ultrasonography. The method was found to be reliable to measure pelvic floor structures at rest and during Valsalva, and might therefore be suitable for identifying dysfunctions in symptomatic patients.
publishDate 2013
dc.date.none.fl_str_mv 2013-03
2014-03-14T13:05:59Z
2014-03-14T13:05:59Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv MURAD-REGADAS, Sthela Maria ; BEZERRA, Leonardo Robson Pinheiro Sobreira ; SILVEIRA, Claudio Regis Sampaio ; PEREIRA, Jacyara deJesus Rosa ; FERANDES, Graziela Olivia da Silva ; VASCONCELOS NETO, José Ananias ; DEALCANFREITAS, Iris Daiana. Anatomical and functional characteristics of the pelvic floor in nulliparous women submitted to three-dimensional endovaginal ultrasonography : case control study and evaluation of interobserver agreement. Revista Brasileira de Ginecologia e Obstetrícia (Impresso), Rio de Janeiro-RJ, v. 35, n. 3, p. 123-129, mar. 2013.
0100-7203
http://www.repositorio.ufc.br/handle/riufc/7676
identifier_str_mv MURAD-REGADAS, Sthela Maria ; BEZERRA, Leonardo Robson Pinheiro Sobreira ; SILVEIRA, Claudio Regis Sampaio ; PEREIRA, Jacyara deJesus Rosa ; FERANDES, Graziela Olivia da Silva ; VASCONCELOS NETO, José Ananias ; DEALCANFREITAS, Iris Daiana. Anatomical and functional characteristics of the pelvic floor in nulliparous women submitted to three-dimensional endovaginal ultrasonography : case control study and evaluation of interobserver agreement. Revista Brasileira de Ginecologia e Obstetrícia (Impresso), Rio de Janeiro-RJ, v. 35, n. 3, p. 123-129, mar. 2013.
0100-7203
url http://www.repositorio.ufc.br/handle/riufc/7676
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Revista Brasileira de Ginecologia e Obstetrícia
publisher.none.fl_str_mv Revista Brasileira de Ginecologia e Obstetrícia
dc.source.none.fl_str_mv reponame:Repositório Institucional da Universidade Federal do Ceará (UFC)
instname:Universidade Federal do Ceará (UFC)
instacron:UFC
instname_str Universidade Federal do Ceará (UFC)
instacron_str UFC
institution UFC
reponame_str Repositório Institucional da Universidade Federal do Ceará (UFC)
collection Repositório Institucional da Universidade Federal do Ceará (UFC)
repository.name.fl_str_mv Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)
repository.mail.fl_str_mv bu@ufc.br || repositorio@ufc.br
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