The role of transperineal ultrasound assessment in the diagnosis of pelvic floor disorder

• Liliya R. Toktar
• Mekan R. Orazov
• Dianna A. Gevorgyan
• Dmitry G. Aryutin
• Yana V. Markina
• Shahlo M. Dostieva
• Ilya A. Maslyukov

Abstract

Aim. To assess the diagnostic value of sonography in women with pelvic floor muscles incompetence.

Material and methods. The main group of study participants consisted of 45 women who had presented with complaints of reduced quality of sexual life and/or perineal discomfort and recurrent discharge from the genital tract, undergone gynecological examination and diagnostic imaging procedures, and been diagnosed with pelvic floor disorder. The mean age of these subjects was 36.48±4.49. The control group consisted of 20 parous women of reproductive age without signs of pelvic floor disorder. Transperineal ultrasound was performed using the Voluson S6 scanner, IC9-RS probe.

Results. Based on the sonography data the most significant parameter was the diastasis of m. bulbo-cavernosus, which was 32 times larger in patients of the main group with pelvic floor disorder (0.642±0.345 vs 0.020±0.050 cm, p<0.01). Compared with the control group, the group with pelvic floor disorder showed a statistically significant decrease in the height of the centrum tendineum (0.618±0.155 vs 1.135±0.113 cm, р<0.01). Other ultrasonic parameters of PFD were also significant. Transperineal ultrasound scanning showed that the width of m. bulbocavernosus and m. puborectalis were 1.5 times less in patients of the main group with pelvic floor incompetence (0.815±0.195 vs 1.21±0.108 cm and 0.60±0.085 vs 0.838±0.121 cm, p<0.01).

Conclusion. The obtained data enable to apply transperineal sonography for early diagnostics in routine medical practice. This method is the least invasive, cheapest, simplest, and most commonly available method for pelvic floor imaging.

Study design. This was a comparative and prospective study.

Keywords:pelvic floor disorder, pelvic organ prolapse, transperineal ultrasound, levator ani

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