The assessment of voluntary pelvic floor muscle contraction by three-dimensional transperineal ultrasonography.

INTRODUCTION AND HYPOTHESIS

The assessment of the levator function by ultrasound has not been fully studied. This study aims to test the validity of ultrasound parameters in the assessment of levator function in women presenting with different pelvic floor structural changes.

METHODS

One hundred and three patients, 36 pelvic organ prolapse women, 36 stress urinary incontinence women and 31 normal controls, were recruited. The images of the midsagittal field and volume datasets at rest and during contraction were acquired. The intra-observer reliability of ultrasound measurements was determined by intraclass correlation coefficients and their 95% CI. Displacement of the bladder neck, sagittal hiatal diameter, levator hiatal angle and levator hiatus area were considered in the assessment. One-way ANOVA was used to determine the significance of differences of the parameters among the three groups.

RESULTS

Ninety-six datasets were analyzed. The parameters measured at rest and during contraction were found to be significantly different, while the parameters representing changes in levator hiatus opening dimensions and displacement of the bladder neck during pelvic floor muscle contraction were found to be not significantly different.

CONCLUSIONS

Ultrasound parameters representing changes in levator hiatus opening dimensions and displacement of the bladder neck during pelvic floor muscle contraction may not be sensitive enough to distinguish the state of the pelvic floor muscle function.