Introduction
There is limited data comparing ultrasound anatomy before and after surgery.

Methods
Novel techniques were developed and validated for the mid-sagittal 2D section measurement of the perineal body (PB), anorectal angle (ARA), anal canal to pubis angle (ACP) and a modified 2D technique for urethral descent. POP-Q, Ultrasound and BBBSQ before and after anterior and posterior colporrhaphy. Prolapse data was compared to nulliparous controls. All data was tested for normality with the Wilk-Shapiro test and analysed accordingly with SPSS and Minitab. An additional POPQ measurement: from the epithelial change border to the midline vestigial skin tag.

Results
N=101 (22 control and 79 prolapse): 54 rectocoele, 54 cystocoele and 39 apical. Perioperative paired data (n=76). The CCT was significantly different in prolapse patients 1.02mm (SD 1.12) and controls 2.25mm (SD 0.62); WSR<0.001. The PB is smaller (mean 1.3cm2 (SD1.6) vs 2.4cm2 (SD 1.7); WSR=0.03. The ACP was more obtuse in prolapse patients [control 98.16° (SD 15.87) vs prolapse 122.90° (SD 15.56); t-test p=0.001]. The ARA is more likely to be central in control patients and Anterior in prolapse(MW-U, p<0.001).

Discussion
The perineal body area, anal canal, anorectal angle, anal canal to pubis angle and a modified 2D technique for urethral descent are validated tools that could be used in clinical practice.

Conclusion
The Null hypothesis can be rejected for urethral descent, the size of the perineal body, anal canal to pubis angle and anorectal angles between prolapse and control patients, or before and after surgery.