Transperineal Ultrasound for Detecting Complications After Pelvic Organ Prolapse and Stress Urinary Incontinence Surgery

ABSTRACT Purpose Assess the roles of two‐dimensional (2D) and three‐dimensional (3D) transperineal ultrasound (TPUS) among women suspected of having complications associated with surgical implantation for pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Methods A retrospective single‐center cohort study was conducted, involving 130 women who underwent either vaginal or abdominal mesh implant placement for the treatment of pelvic organ prolapse (POP) or stress urinary incontinence (SUI) between January 2017 and December 2024. The position and mobility of the slings were dynamically assessed using 2D and 3D TPUS at rest and during the Valsalva maneuver. Results Among 130 patients, 24 were categorized as symptomatic and 106 as asymptomatic. 89.2% (116/130) had one implant, while the remaining patients had two or more implants. Mid‐urethral slings (MUS) were the most prevalent implants [63.8% (83/130)]. Chronic pelvic or abdominal pain was the most frequent clinical symptom [16.9% (22/130)]. There were more mesh implants in the symptomatic group [45.8% (11/24)] than in the asymptomatic group [3.8% (4/106)]. The sensitivity and specificity of transperineal ultrasound in detecting complications after pelvic floor sling surgery are approximately 89% and 92%, respectively. Conclusion Transperineal 2D and 3D ultrasound effectively evaluates the position and mobility of pelvic mesh implants, demonstrating high sensitivity and specificity in detecting postoperative complications.