Ultrasonography

Abstract

The complex anatomy and function of the pelvic floor is not yet fully understood. Understanding how muscles, nerves, ligaments, and fasciae interact and relate to pelvic organs is fundamental to establish what disease processes are involved in urinary incontinence and voiding dysfunctions. In the last two decades, growing attention has been paid to both increasing understanding of pelvic floor anatomy and improving technologies for diagnosis. Transperineal ultrasonography (TPUS) has become a valuable tool in the diagnostic workup of patients with urinary incontinence and voiding dysfunctions. The advent of high-resolution three-dimensional endovaginal ultrasonography (3D-EVUS) promises to further improve the imaging of pelvic floor anatomy; however, at present, the absence of standardization of the procedure limits its usefulness. The lack of uniformity frequently leads to confusion in the assessment of an image by the interpreting ultrasonographer. The equipment used, patient position, technique of examination, and manner of performing measurements may differ from one examiner to another and may influence the correct identification of pelvic floor structures. The aim of this chapter is to review basic information about techniques, equipment advantages, limitations, clinical usefulness, and the literature concerning ultrasound assessment in the diagnostics and monitoring of treatment of urinary incontinence and voiding dysfunctions with reference to two-dimensional (2D) and 3D-TPUS techniques, as well as 2D and 3D-EVUS. © 2010 Springer-Verlag Milan.