E-Posters-How to define 'Significant Enterocele' on Translabial Imaging?

How to define 'Significant Enterocele' on Translabial Imaging? - Nishamini Subramaniam, MBBChBAO, MRCOG

Pdf Summary

This pilot study aimed to define a criterion value for "significant enterocele" on trans-labial imaging to predict symptoms of prolapse. The study included patients with pelvic floor dysfunction who underwent interview, 4D trans-labial ultrasound (TLUS), and POP-Q assessment. The results showed that symptoms of prolapse were present in 50.4% of women, and clinically significant pelvic organ prolapse (POP) was found in 78.5% of women. On TLUS, the mean position of the bladder, uterus, and rectum during Valsalva maneuver was measured. A total of 83 women were diagnosed with enterocele on TLUS, of which 65 were symptomatic. However, symptoms of prolapse were not significantly associated with enterocele on imaging. Using receiver operator characteristic (ROC) analysis, a cut-off of 13 mm below the pubis for enterocele was established, with a sensitivity of 0.66 and a specificity of 0.61. When analyzing women who had undergone hysterectomy, a cutoff of 13 mm provided improved sensitivity (0.71) and specificity (0.68). The study concluded that there was no significant association between enterocele and prolapse symptoms, likely due to power issues. The authors proposed using a cut-off of 13 mm for both rectocele and enterocele, as the cut-off for significant descent of the rectal ampulla is 15 mm below the symphysis pubis. Overall, this pilot study provides insights into defining "significant enterocele" on trans-labial imaging to predict symptoms of prolapse.

Keywords

pilot study

significant enterocele

trans-labial imaging

symptoms of prolapse

pelvic floor dysfunction

4D trans-labial ultrasound

POP-Q assessment

pelvic organ prolapse

Valsalva maneuver

cut-off value