Ultrasound for Women’s Pelvic Floor Dysfunction

In the past, clinicians managing female pelvic floor disorders focused on functional assessment using urodynamics studies and urethral pressure profilometry. Anatomical assessment was made by clinical examination alone. Under special conditions when an imaging technique for anatomical assessment of the female pelvic floor disorder is perceived necessary, contrast X-ray techniques is used.1,2 The complexity of the setup for these procedures and the risk of radiation exposure limits its routine clinical application. The advent of ultrasonography (USG) and magnetic resonance imaging (MRI) enable clinicians to have a safe and convenient tool to assess female pelvic floor disorders. The new tools provide a better assessment of soft tissue support (the primary event in pelvic floor trauma) in the female pelvic floor compared to contrast X-ray. USG has the added advantage of being a standard piece of office equipment in gynecological practice which makes it an inexpensive and extremely convenient tool to use. Real-time assessment using USG is able to delineate functional anatomy of female pelvic floor disorders. To date, USG assessment of female pelvic floor disorders is not yet used in routine clinical practice. However, researches using USG unveiled a number of functional anatomical phenomenon in women’s pelvic floor disorders, such as trauma to pelvic floor in childbirth, the mechanism of female continence, the mechanics of how tension free vaginal tape (TVT) works and the anatomical reasons for why some TVT procedures failed.3-5 It is also a statistically more sensitive tool to assess outcomes after intervention compared to clinical examination alone.