Abstract：Objective: To investigate the application value of transperineal four-dimensional(4D) ultrasound in female patients with bladder prolapse． Methods: Transperineal 4D ultrasound was performed in 40 cases of normal puerpera and 40 cases of female patients with bladder prolapse. In condition of resting and tension, the real-time movement of pelvic organ was investigated and the relevant parameters of bladder urethral and levator hiatus were measured in median sagital plane and three-dimensional(3D) reconstruct plane. Different types of bladder prolapse were diagnosed according to Green. Results: In median sagital plane, there was no significant difference in the horizontal distence of bladder neck to symphysis pubis between bladder prolapse group and control group(P＞0.05) in rest period, but the angles of retrovesical were larger in bladder prolapse group than in control group(P＜0.05). In tension period, the horizontal distances of bladder neck to symphysis pubis were changed from negative to positive in bladder prolapse group. But the negative were only decreased in control group, the bladder neck movement degrees, retrovesical angles, urethral rotation angles were significantly larger in bladder prolapse group than those in control group(P＜0.05). There were 4 cases typeⅠ, 24 cases type Ⅱ and 12 cases type Ⅲ by Green in bladder prolapse group. In 3D reconstruct plane, the hiatus’ left-right diameter, anteroposterior diameter, circumference and area were measured and determined, all of which were larger in bladder prolapse group than in control group(P＜0.05), but there was no significant difference in the angle of puborectalis between bladder prolapse group and control group(P＞0.05). In tension period, all the indicators of bladder prolapse group were increased significantly compared with the control group(P＜0.05). In prolapse group, puborectalis was not avulsion, the levator-uretha gaps were zygomorphy and the gaps were all less than 25 mm with tomographic ultrasound imaging(TUI) in constraction period. Conclusions: The transperineal 4D ultrasound can be used to dynamic observe bladder prolapse, distinguish different types of bladder prolapse and evaluate the pelvic floor anatomy and function of bladder prolapse, which is worthy of clinical popularization and application．
2015, Vol. 26 
