Author(s)

Jonia Alshiek^1,2, Qi Wei³, Lieschen H. Quiroz⁴, Mikio A. Nihira⁵, Menahem Neuman⁶, S. Abbas Shobeiri^1,3*

¹Department of Obstetrics & Gynecology, INOVA Women’s Hospital, Falls Church, USA.
²Department of Obstetrics and Gynecology, Hillel Yafe Medical Center, Hadera, Israel.
³Department of Bioengineering, George Mason University, Fairfax, USA.
⁴Department of Obstetrics & Gynecology, The University of Oklahoma Health Sciences Center, Oklahoma City, USA.
⁵Department of Obstetrics & Gynecology, The University of California, Riverside, USA.
⁶Urogynecology, Women Health Division, Galilee MC, Nahariya, Faculty of Medicine, Bar Ilan University, Ramat Gan, Israel.

Objective: To determine whether endovaginal ultrasound is a reliable measure in visualization of the sacrospinous ligament among women with prolapse versus women without prolapse, and thus might be clinically applicable in the design of an ultrasound-guided device for performing sacrospinous ligament anchor placement as a treatment for pelvic organ prolapse. Methods: In the first phase of this study we performed a sacrospinous anchor placement in four normal fresh-frozen female pelves. Afterwards, an endovaginal ultrasound was performed to visualize the anchor localization which was validated by dissection of the cadaveric pelves. In the second phase of the study: two groups of volunteer females with and without pelvic organ prolapsed (POP-group, vs NON-POP group) were evaluated by endovaginal ultrasound to localize the sacrospinous ligament. Results: Cadaveric dissection demonstrated accurate anchor placement into the 8/8 sacrospinous ligament. We performed endovaginal ultrasound in a total of 17 N-POP and 10 (POP) patients. Among the N-POP group, the right and left ischial spines were visible in 6/17 (35%) and (6/17) 35% vs 0/10 (0%) for both right and left sides in POP group (p = 0.008). The right sacrospinous ligament was visualized in 4/17 (23%) N-POP subjects and 0/10 POP subjects (p = 0.27) and the left sacrospinous ligament was visualized in 7/17 (41%) N-POP subjects and 2/10 POP subjects (p = 0.48). Conclusions: Sacrospinous ligament and the ischial spines couldn’t be reliably visualized among women with or without pelvic organ prolapse using endovaginal ultrasound, although the structures are visualized more in some of the non-prolapsed women. The sacrospinous anchoring device demonstrated accurate placement by cadaveric dissections.

Sacrospinous Ligament, Pelvic Organ Prolapse, Endovaginal Ultrasound

Alshiek, J. , Wei, Q. , Quiroz, L. , Nihira, M. , Neuman, M. and Shobeiri, S. (2019) The Utility of Endovaginal Ultrasound in the Design of a Sacrospinous Ligament Anchoring Device in Patients with and without Pelvic Organ Prolapse. Open Journal of Obstetrics and Gynecology, 9, 1103-1113. doi: 10.4236/ojog.2019.98107.