OC26.03: Pelvic floor dysfunction at three‐dimensional transperineal ultrasound in women affected by deep infiltrating endometriosis

Pelvic floor muscle dysfunction seems to play an important role in pathophysiology of pain symptoms and pelvic organs' alterations in women with pelvic syndromes, including deep infiltrating endometriosis (DIE).The aim of the present study was to evaluate the morphometry of PFM in women affected by DIE in comparison to controls using three-dimensional transperineal ultrasound. A prospective, case–control study was conducted between March and November 2015 on nulliparous women scheduled for laparoscopic surgery for deep infiltrating endometriosis (study group) or other benign gynecological diseases (control group). Before surgery, pelvic hiatal area, anorectal angle and levator plate angle were assessed at rest using three-dimensional transperineal ultrasound. Sixty-eight patients were enrolled in the study: 34 in the study group and 34 in the control group. Diagnosis of endometriosis was confirmed by histological examination of the surgical specimens in all cases of study group. All patients of control group did not show signs of endometriotic implants at diagnostic laparoscopy. Compared to control group, patients with DIE showed a smaller pelvic hiatal area (11.2 ± 2.0 cm2 versus 13.2 ± 2.2 cm2, p < 0.001), a narrower anorectal angle (108.3 ± 11.9 grade versus 116.2 ± 12.0 grade, p < 0.01) and a narrower levator plate angle, although this latter did not reach statistical significance (19.2 ± 6.4 grade versus 24.7 ± 6.2 grade, p = 0.6). Using three-dimensional transperineal ultrasound, women with DIE have different morphometric values of PFM compared to controls, suggesting a higher pelvic floor muscular tone. Three-dimensional transperineal ultrasound could represent a useful and pain-free method to detect PFM hypertonia in women with endometriosis.