# The application of transperineal ultrasonography combined with shear wave elastography in the evaluation and monitoring of pelvic floor function in the early stage after total hysterectomy

## TL;DR

This study shows that transperineal ultrasound and SWE can effectively monitor pelvic floor function changes after hysterectomy, with TAH causing more damage.

## Contribution

The study introduces a combined imaging approach using transperineal ultrasound and SWE for evaluating pelvic floor function post-hysterectomy.

## Key findings

- Pelvic floor functions begin to weaken three months after total hysterectomy.
- TAH causes more significant damage to pelvic floor structures and functions compared to LTH.

## Abstract

•This study explores imaging assessment of pelvic floor function after hysterectomy.•The TAH can cause more significant damage to the pelvic floor structure and function.•Transperineal ultrasound and SWE assess pelvic floor function in multiple dimensions.

This study explores imaging assessment of pelvic floor function after hysterectomy.

The TAH can cause more significant damage to the pelvic floor structure and function.

Transperineal ultrasound and SWE assess pelvic floor function in multiple dimensions.

To investigate the combined effect of transperineal ultrasound and Shear Wave Elastography (SWE) in the evaluation and monitoring of pelvic floor functions after total hysterectomy.

Fifty-two women who planned to undergo total hysterectomy from January 2019 to December 2022 in Nantong Third People's Hospital were selected, and the pelvic floor functions were assessed using transperineal ultrasound combined with SWE. The dynamic alterations in pelvic floor functions at different time points were compared after hysterectomy. The differences in pelvic floor parameters were compared between Transabdominal Total Hysterectomy (TAH) and Laparoscopic Total Hysterectomy (LTH).

The Posterior Urethravesical Angle at rest and Valsalve maneuver (R-PUA, V-PUA), antero-posterior diameter of the hiatus at rest and Valsalve maneuver (R-HAPD, V-HAPD), and elastic modulus of left and right puborectalis at rest (R-L-PRE, R-R-PRE), the Urethral Rotation Angle (URA)were obviously higher at 3 mon after surgery than before surgery and at 1-mon after surgery; the bladder neck-symphyseal distance at rest and Valsalve maneuver (R-BSD,V-BSD), and the difference in elasticity between the left and right puborectalis muscles (L-∆E, R-∆E) were markedly lower at 3 mon than before surgery and at 1 mon after surgery; V-BSD, L-∆E, R-∆E were obviously decreased and the Bladder Neck Descen (BND), URA, V-PUA were obviously increased in the TAH group in comparison with the LTH group.

Pelvic floor functions start to be weak at 3 months after total hysterectomy. TAH causes more significant damage to the structures and functions of the pelvic floor.