Endoluminal ultrasonography

Abstract

The pathophysiology of pelvic organ prolapse (POP) is complex. The most common mechanisms underlying pelvic floor disorders are represented by damages to the connective tissue supporting the pelvic organs and to the levator ani muscle occurring during childbirth. Management of POP still seems to be guided largely by personal preferences and experience rather than evidence-based medicine. Diagnostic tests frequently result in a revised initial management plan; however, no guidelines exist concerning their optimal use in a clinical practice setting, and their use as a routine strategy appears not to be an option. The advent of high-resolution three-dimensional ultrasonography and dynamic ultrasonography has improved our understanding of pelvic floor function. On the basis of ultrasonographic findings, additional tests may be performed in selected conditions to optimize treatment planning and to identify the reason for surgical failure. © 2010 Springer-Verlag Milan.