Diagnostic application of pelvic floor muscle strength scoring combined with pelvic floor ultrasound in pelvic floor dysfunction

Yuan Cuicui; Gao Jie; Xue Xiurong; Chang Hongkun; Xie Li

doi:10.11986/j.issn.1673-873X.2023.12.008

Abstract：Objective To explore the diagnostic value of pelvic floor muscle strength scoring in combination with pelvic floor ultrasound in patients with pelvic floor dysfunction.Methods From June 2021 to June 2022,75 patients with pelvic floor dysfunction admitted to our hospital were selected as the pelvic floor dysfunction group,and another 75 healthy females who underwent health check-ups during the same period as the control group.Both groups underwent pelvic floor muscle strength examination and pelvic floor ultrasound examination.The pelvic floor muscle strength scores and pelvic floor ultra-sound parameters[anteroposterior diameter(AP),left-right diameter(LR),and hiatal area(HA)of the hiatal foramen]were compared between the two groups.The influencing factors of pelvic floor dysfunction were analyzed,and the diagnostic value of different examination methods for pelvic floor dysfunction was assessed using the receiver operating characteristic(ROC)curve.Results The pelvic floor muscle strength score of the control group was(4.50±0.50)points,and that of the pelvic floor dysfunction group was(2.50±0.50)points,with statistical significance(P＜0.05).In both resting and a-nal contraction states,the AP,LR,and HA of the pelvic floor dysfunction group were significantly higher than those of the control group(P＜0.05).Logistic regression analysis showed that a higher pelvic floor muscle strength score was a protec-tive factor for pelvic floor dysfunction,with a higher score indicating a lower likelihood of developing pelvic floor dysfunc-tion.Higher AP,LR,and HA values were risk factors for pelvic floor dysfunction,with higher values indicating a higher likelihood of developing the condition.The ROC curves showed that the area under the curve(AUC)for diagnosing pelvic floor dysfunction using pelvic floor muscle strength score,AP at rest,LR at rest,HA at rest,AP during anal contraction,LR during anal contraction,and HA during anal contraction were 0.819,0.800,0.876,0.657,0.914,0.884,and 0.913,respectively.A combined diagnostic model was constructed based on the results of logistic regression analysis,and the ROC curve analysis revealed that the AUC for combined diagnosis was 0.974.Conclusion Pelvic floor muscle strength scoring and pelvic floor ultrasound parameters can both diagnose pelvic floor dysfunction,but the combined application of these two examination methods demonstrated higher AUC,sensitivity,specificity,and accuracy,holding promise for a wider clinical application.