The Value of Levator Plate Angle Measurement by Ultrasound in the Assessment of Pelvic Organ Prolapse in Elderly Women

CHEN Ping; SHE Lingna; Pan Ru; CHEN Liyan; ZHANG Bosen

doi:10.3639/j.issn.2095-3097.2025.09.018

Abstract：Objective To explore the application value of pelvic floor ultrasound measurement of the levator plate angle(LPA)in the diagnosis of pelvic organ prolapse(POP)in elderly women.Methods A prospective study design was used.Fifty elderly POP patients admitted to Meizhou People's Hospital from January 2021 to July 2023 were selected as the study group,and 50 healthy elderly women who underwent physical examination during the same period were included as the control group.Both groups underwent pelvic floor ultrasound examination.The LPA values at rest and during maximum Valsalva maneuver were measured,and the difference between the two(ΔLPA)was calculated.The differences in these indicators were compared between the two groups,and receiver operating characteristic(ROC)curves were plotted to analyze their diagnostic value for POP.The POP-Q staging in the study group was recorded,and its correlation with LPA-related parameters was analyzed.Results The LPA values at rest and during maximum Valsalva maneuver were significantly smaller in the study group than in the control group(P<0.05),while the ΔLPA was greater(P<0.05).The ROC curve showed that the AUCs of resting LPA,LPA during maximum Valsalva maneuver,and ΔLPA for diagnosing POP were 0.966,0.992,and 0.642,respectively(P<0.05).Among them,the AUCs of resting LPA and LPA during maximum Valsalva maneuver for diagnosing POP were both greater than that of ΔLPA(P<0.001).Kendall's tau-b correlation coefficient analysis showed that the degree of uterine prolapse and anterior vaginal wall prolapse were negatively correlated with resting LPA and LPA during Valsalva maneuver(rResting LPA-Uterine prolapse degree=-0.472,rResting LPA-Anterior vaginal wall prolapse degree=-0.305,rMaximum Valsalva maneuver LPA-Uterine prolapse degree=-0.563,rMaximum Valsalva maneuver LPA-Anterior vaginal wall prolapse degree=-0.441),and positively correlated with ΔLPA(rUterine prolapse degree=0.274,rAnterior vaginal wall prolapse degree=0.203;P<0.05).The degree of posterior vaginal wall prolapse was not correlated with any LPA-related parameters(P>0.05).Conclusion LPA can be used to guide the diagnosis of POP in elderly women,and its value is correlated with the degree of prolapse.Among LPA-related parameters,the LPA value during Valsalva maneuver has the highest clinical evaluation value.