Trends in Clinical and Medical Sciences

Special issue: Indian Medical Research Views and Findings on Last 5 years (2023), pp. 371 – 378
ISSN: 2791-0814 (online) 2791-0806 (Print)
DOI: 10.30538/psrp-tmcs2023.si-imrv057

Association of clinical outcome with elastographic changes following pelvic floor muscle training (kegels exercises) in patients with pelvic organ prolapse- stage 1/stage 2

Mrinalini Singh\(^{1, *}\), Rehana Najam\(^{2}\), Pinki Lohan\(^{3}\), Rajul Rastogi\(^{4}\) and Astha Lalwani\(^{2}\)
\(^{1}\) Postgraduate Student, Department of Obstetrics and Gynecology, Teerthanker Mahaveer Medical College & Research Centre, Moradabad, Uttar Pradesh, India.
\(^{2}\) Professor, Department of Obstetrics and Gynecology, Teerthanker Mahaveer Medical College & Research Centre, Moradabad, Uttar Pradesh, India.
\(^{3}\) Postgraduate Student, Department of Medicine, Teerthanker Mahaveer Medical College & Research Centre, Moradabad, Uttar Pradesh, India.
\(^{4}\) Professor, Department of Radiology, Teerthanker Mahaveer Medical College & Research Centre, Moradabad, Uttar Pradesh, India.
Correspondence should be addressed to Mrinalini Singh at dr.mrinalinisingh@yahoo.com

Copyright © 2023 Mrinalini Singh, Rehana Najam, Pinki Lohan, Rajul Rastogi and Astha Lalwani. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: December 30, 2022 – Accepted: May 5, 2023 – Published: May 20, 2023

Abstract

Introduction: Elastography has emerged as a valuable diagnostic method for assessing the integrity of the pelvic floor muscles. It measures tissue stiffness and deformation in response to compression, providing a non-invasive and objective assessment of tissue stiffness using gray-scale ultrasonography. In this study, we aim to evaluate the clinical outcomes and elastographic changes following Pelvic Floor Muscle Training (Kegel Exercises) among patients with Pelvic Organ Prolapse in Stage 1 and Stage 2.
Materials & Methods: Patients eligible for the study were enrolled after obtaining written informed consent, ensuring the confidentiality of their details. Detailed history, general examination, systemic examination, and local examination were performed following standard protocols. Per speculum examination was conducted to determine the degree of prolapse based on POP-Q staging. Transperineal Elastography was performed on women diagnosed with Stage 1 or Stage 2 POP to evaluate Pelvic floor dysfunction. Study participants were instructed on how to perform Kegel exercises and were followed up. Clinical and elastography scores were recorded and analyzed.
Results: Out of 120 subjects, 56 had a clinical score of 3 (46.7%) and 52 had a clinical score of 4 (43.3%) at the 1st month evaluation. For elastography scores, 60 subjects had an ES2 score (50%) and 60 had an ES3 score (50%). After 6 months of performing Kegel exercises as prescribed, 44 subjects had a clinical score of 1 (36.7%), 32 had a clinical score of 2 (26.7%), and 44 had a clinical score of 3 (36.7%). In terms of elastography scores, 48 subjects had an ES4 score (40%), 48 had an ES3 score (40%), and 24 had an ES2 score (20%). There was a statistically significant difference between the baseline clinical and elastography scores and the scores at 6 months (p<0.05).
Conclusion: The results of this study indicated that pelvic organ prolapse stage and levator ani distension in women were correlated with the elasticity properties measured by elastography. Further research is required to explore the relationship between pelvic floor elasticity characteristics and clinical data.

Keywords:

Elastography; Prolapse; Levator ani; Pelvic floor.