The Utility of Endovaginal Ultrasound in the Design of a Sacrospinous Ligament Anchoring Device in Patients with and without Pelvic Organ Prolapse ()
Affiliation(s)
1Department of Obstetrics & Gynecology, INOVA Women’s Hospital, Falls Church, USA.
2Department of Obstetrics and Gynecology, Hillel Yafe Medical Center, Hadera, Israel.
3Department of Bioengineering, George Mason University, Fairfax, USA.
4Department of Obstetrics & Gynecology, The University of Oklahoma Health Sciences Center, Oklahoma City, USA.
5Department of Obstetrics & Gynecology, The University of California, Riverside, USA.
6Urogynecology, Women Health Division, Galilee MC, Nahariya, Faculty of Medicine, Bar Ilan University, Ramat Gan, Israel.
ABSTRACT
Objective: To determine whether endovaginal ultrasound is a reliable measure in
visualization of the sacrospinous ligament among women with prolapse versus
women without prolapse, and thus might be clinically applicable in the design
of an ultrasound-guided device for performing sacrospinous ligament anchor
placement as a treatment for pelvic organ prolapse. Methods: In the
first phase of this study we performed a sacrospinous anchor placement in four
normal fresh-frozen female pelves. Afterwards, an endovaginal ultrasound was
performed to visualize the anchor localization which was validated by
dissection of the cadaveric pelves. In the second phase of the study: two
groups of volunteer females with and without pelvic organ prolapsed (POP-group,
vs NON-POP group) were evaluated by endovaginal ultrasound to localize the
sacrospinous ligament. Results: Cadaveric dissection demonstrated
accurate anchor placement into the 8/8 sacrospinous ligament. We performed
endovaginal ultrasound in a total of 17 N-POP and 10 (POP) patients. Among the
N-POP group, the right and left ischial spines were visible in 6/17 (35%) and
(6/17) 35% vs 0/10 (0%) for both right and left sides in POP group (p = 0.008).
The right sacrospinous ligament was visualized in 4/17 (23%) N-POP subjects and
0/10 POP subjects (p = 0.27) and the left sacrospinous ligament was visualized
in 7/17 (41%) N-POP subjects and 2/10 POP subjects (p = 0.48). Conclusions: Sacrospinous ligament and the ischial spines couldn’t be reliably visualized
among women with or without pelvic organ prolapse using endovaginal ultrasound,
although the structures are visualized more in some of the non-prolapsed women.
The sacrospinous anchoring device demonstrated accurate placement by cadaveric
dissections.
Share and Cite:
Alshiek, J. , Wei, Q. , Quiroz, L. , Nihira, M. , Neuman, M. and Shobeiri, S. (2019) The Utility of Endovaginal Ultrasound in the Design of a Sacrospinous Ligament Anchoring Device in Patients with and without Pelvic Organ Prolapse.
Open Journal of Obstetrics and Gynecology,
9, 1103-1113. doi:
10.4236/ojog.2019.98107.
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