{"paper_id":"6e118b1f-a007-4897-975b-90822002c6a5","body_text":"Abstract\nPurpose\nTo assess the elasticity of the pelvic floor muscle (PFM) affected by deep infiltrating endometriosis (DIE) with transperineal elastography.\nMethods\nThis prospective observational study included 88 patients who were diagnosed with DIE, ovarian endometrioid cyst, or ovarian teratoma. All the patients were assigned to one of the three groups and underwent transperineal elastography. The scoring system and strain ratio (SR) values were recorded and analyzed. Assessments were conducted at maximal Valsalva and under quiescent condition, respectively.\nResults\nThe mean elastography score was statistically significantly higher for the levator ani of group I than groups II and III under quiescent condition. In addition, SR of the levator ani in group I was higher than that in groups II and III. However, at maximal Valsalva, the mean elastography score of group I was lower than that of groups II and III. In addition, SR of group I was lower than that of groups II and III.\nConclusion\nThe elasticity of the PFM in DIE patients could be qualitatively evaluated by transperineal elastography. The coordination of the PFM was injured and decreased elasticity appeared in DIE patients.\nSimilar content being viewed by others\nReferences\nGiudice LC. Clinical practice. Endometriosis. N Engl J Med. 2010;362:2389–98.\nKoninckx PR, Meuleman C, Demeyere S, et al. Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain. Fertil Steril. 1991;55:759–65.\nKoninckx PR, Ussia A, Adamyan L, et al. Deep endometriosis: definition, diagnosis, and treatment. Fertil Steril. 2012;98:564–71.\nBaker PK. Musculoskeletal origins of chronic pelvic pain—diagnosis and treatment. Obstet Ginecol Clin North Am. 1993;20:719–43.\nFitzGerald MP, Kotarinos R. Rehabilitation of the short pelvic floor I: background and patient evaluation. Int Urogynecol J. 2003;14:261–8.\nDos Bispo AP, Ploger C, Loureiro AF, et al. Assessment of pelvic floor muscles in women with deep endometriosis. Arch Gynecol Obstet. 2016;294:519–23.\nButrick CW. Pelvic floor hypertonic disorders: identification and management. Obstet Gynecol Clin North Am. 2009;36:707–22.\nRaimondo D, Youssef A, Mabrouk M, et al. Pelvic floor muscle dysfunction on D/4D transperineal ultrasound in patients with deepinfiltrating endometriosis: a pilot study. Ultrasound Obstet Gynecol. 2017;50:527–32.\nLyshchik A, Higashi T, Asato R, et al. Thyroid gland tumor diagnosis at US elastography. Radiology. 2005;237:202–11.\nHeim LJ. Evaluation and differential diagnosis of dyspareunia. Am Fam Physician. 2001;63:1535–44.\nButrick CW. Pathophysiology of pelvic floor hypertonic disorders. Obstet Gynecol Clin North Am. 2009;36:699–705.\nYap EC. Myofascial pain—an overview. Ann Acad Med Singap. 2007;36:43–8.\nMabrouk M, Raimondo D, Del Forno S, et al. Pelvic floor muscle assessment at -and 4-dimensional transperineal ultrasound in women with endometriosis, with or without retroperitoneal infiltration: a step towards complete functional assessment. Ultrasound Obstet Gynecol. 2018;52:265–8 (Epub ahead of print).\nXie M, Zhang X, Liu J, et al. Evaluation of levator ani with no defect on elastography in women with POP. Int J Clin Exp Med. 2015;8:10204–12.\nXie M, Zhang X, Zhang X, et al. Can we evaluate the levator ani after Kegel exercise in women with pelvic organ prolapse by transperineal elastography? A preliminary study. J Med Ultrasonics. 2018;45:437–41.\nAcknowledgements\nThis study was supported by a grant from the fund for scientific research of Chinese Preventive Medicine Association (Grant no. 201809031).\nAuthor information\nAuthors and Affiliations\nCorresponding authors\nEthics declarations\nConflict of interest\nWe declare that we have no conflicts of interest.\nEthical approval\nThe study design and protocol were approved by the Institutional Review Board of the Obstetrics and Gynecology Hospital of Fudan University, Shanghai, P. R. China. In addition, all patients gave written informed consent after the procedure was explained fully.\nAbout this article\nCite this article\nXie, M., Feng, Y., Zhang, X. et al. Evaluation of pelvic floor muscle by transperineal elastography in patients with deep infiltrating endometriosis: preliminary observation. J Med Ultrasonics 46, 123–128 (2019). https://doi.org/10.1007/s10396-018-0913-y\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s10396-018-0913-y","source_license":"CC0","license_restricted":false}