Objectives: Comprehensive assessment of the pelvic floor (PF) provides information and diagnoses of coexisting abnormalities which may affect operative decisions.
Our aim was to establish if pre-operative pelvic floor ultrasonography (PFUS) in patients complaining of PF dysfunction can complement clinical findings and contribute to additional management strategies.
Methods: Women were recruited from the (urogynaecology/gynaecology clinics between July and October 2009 and underwent pelvic organ prolapse quantification (POPQ) by an independent examiner. PFUS was performed using two dimensional (2D) transperineal ultrasound (TPUS), high frequency 2D/three dimensional (3D) endovaginal ultrasound (EVUS) using a biplane probe with linear and transverse arrays and a 360° rotational 3D-EVUS. The clinician performing PFUS was blinded to POPQ results. POPQ and PFUS were repeated at one year. Two clinicians analysed the scans independently.
Results: 158 of 160 women had a POPQ and PFUS. 105 women had pelvic organ prolapse and/or incontinence and 53 asymptomatic women were controls. Twenty six additional ultrasound diagnoses were noted at baseline and 46 at 1 year using 2D-TPUS and EVUS. Only one woman with additional diagnoses on PFUS needed surgical intervention for this condition.
Conclusions: Multicompartment PFUS identifies additional conditions to that diagnosed on clinical assessment. However, it neither changes the initial surgical management nor the management at one year follow-up and therefore clinical assessment should not be substituted by PFUS.
Advances in knowledge: PFUS can be helpful in providing additional information however, it does not change the initial management of the patient and therefore cannot replace clinical assessment.
Written by:
Lone F, Sultan A, Stankiewicz A, Thakar R. Are you the author?
Subspecialty trainee Urogynaecology Department of Obstetrics and Gynaecology Croydon University Hospital, UK.
Reference: Br J Radiol. 2014 Jun 24:20140145.
doi: 10.1259/bjr.20140145
PubMed Abstract
PMID: 24959953
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