Evaluation of pelvic floor muscle by transperineal elastography in patients with deep infiltrating endometriosis: preliminary observation

Meng Xie, Yu Feng, Xuyin Zhang, Keqin Hua, Yunyun Ren, Wenping Wang
Journal of medical ultrasonics (2001) · 2018 · vol. 46(1) , pp. 123–128 · doi:10.1007/s10396-018-0913-y · PMID:30361789 · W2898407356
article OA: closed CC0 ⤵ 5 in-corpus citations
Full text JSON View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06+body, 2026-06-07 ⓘ

Transperineal elastography was used to assess pelvic floor muscle elasticity in patients with deep infiltrating endometriosis, finding injured coordination and decreased elasticity compared to control groups.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This prospective observational study assessed pelvic floor muscle (PFM) elasticity in 88 women diagnosed with deep infiltrating endometriosis (DIE), ovarian endometrioid cysts, or ovarian teratomas using transperineal elastography. Elastography scoring and strain ratio values for the levator ani were recorded at maximal Valsalva and under quiescent conditions and compared across three groups. Under quiescent conditions, group I (DIE) showed higher mean elastography scores and higher strain ratios for the levator ani than the other groups, whereas at maximal Valsalva group I showed lower mean scores and lower strain ratios, indicating impaired coordination and decreased elasticity in DIE. This paper is centrally about endometriosis — it specifically evaluates pelvic floor muscle elasticity in patients with deep infiltrating endometriosis using transperineal elastography.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Full text 4,486 characters · extracted from oa-doi-fallback · 6 sections · click to expand

Abstract

Purpose To assess the elasticity of the pelvic floor muscle (PFM) affected by deep infiltrating endometriosis (DIE) with transperineal elastography.

Methods

This 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.

Results

The 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.

Conclusion

The 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. Similar content being viewed by others

References

Giudice LC. Clinical practice. Endometriosis. N Engl J Med. 2010;362:2389–98. Koninckx 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. Koninckx PR, Ussia A, Adamyan L, et al. Deep endometriosis: definition, diagnosis, and treatment. Fertil Steril. 2012;98:564–71. Baker PK. Musculoskeletal origins of chronic pelvic pain—diagnosis and treatment. Obstet Ginecol Clin North Am. 1993;20:719–43. FitzGerald MP, Kotarinos R. Rehabilitation of the short pelvic floor I: background and patient evaluation. Int Urogynecol J. 2003;14:261–8. Dos 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. Butrick CW. Pelvic floor hypertonic disorders: identification and management. Obstet Gynecol Clin North Am. 2009;36:707–22. Raimondo 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. Lyshchik A, Higashi T, Asato R, et al. Thyroid gland tumor diagnosis at US elastography. Radiology. 2005;237:202–11. Heim LJ. Evaluation and differential diagnosis of dyspareunia. Am Fam Physician. 2001;63:1535–44. Butrick CW. Pathophysiology of pelvic floor hypertonic disorders. Obstet Gynecol Clin North Am. 2009;36:699–705. Yap EC. Myofascial pain—an overview. Ann Acad Med Singap. 2007;36:43–8. Mabrouk 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). Xie 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. Xie 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.

Acknowledgements

This study was supported by a grant from the fund for scientific research of Chinese Preventive Medicine Association (Grant no. 201809031). Author information Authors and Affiliations Corresponding authors Ethics declarations Conflict of interest We declare that we have no conflicts of interest. Ethical approval The 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. About this article Cite this article Xie, 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 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s10396-018-0913-y

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

mesh:D004715endometriosisdie_deep_infiltrating

MeSH descriptors

Elasticity Imaging Techniques Endometriosis Pelvic Floor Adult Cysts Cysts Elasticity Endometriosis Endometriosis Female Humans Imaging, Three-Dimensional Middle Aged Ovarian Neoplasms Ovarian Neoplasms Pelvic Floor Pelvic Floor Prospective Studies Teratoma Teratoma

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (15)

Cited by (5)

Source provenance

europepmc
last seen: 2026-06-04T01:30:01.192114+00:00
openalex
last seen: 2026-06-04T00:00:01.174412+00:00
pubmed
last seen: 2026-05-13T22:19:31.300640+00:00
License: CC0 · commercial use OK