TITLE:
The Utility of Endovaginal Ultrasound in the Design of a Sacrospinous Ligament Anchoring Device in Patients with and without Pelvic Organ Prolapse
AUTHORS:
Jonia Alshiek, Qi Wei, Lieschen H. Quiroz, Mikio A. Nihira, Menahem Neuman, S. Abbas Shobeiri
KEYWORDS:
Sacrospinous Ligament, Pelvic Organ Prolapse, Endovaginal Ultrasound
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.8,
August
9,
2019
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.