Levator ani defects in patients with stress urinary incontinence: three-dimensional endovaginal ultrasound assessment

Hegde, Aparna; Aguilar, Vivian C.; Davila, G. Willy

doi:10.1007/s00192-016-3068-7

Cited by 7 publications

(2 citation statements)

References 30 publications

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“…US functional dysfunction is one of the pathophysiological mechanisms of SUI. In SUI patients, PR muscle defect was the strongest contribution to the PFM loss and inverse [ 39 ]. It is consistent with the PR anomaly we have found in B group.…”

Section: Discussionmentioning

confidence: 99%

Multifunctional Evaluation Technology for Diagnosing Malfunctions of Regional Pelvic Floor Muscles Based on Stretchable Electrode Array Probe

et al. 2023

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The pelvic floor dysfunction (PFD) has become a serious public health problem. Accurate diagnosis of regional pelvic floor muscle (PFM) malfunctions is vitally important for the prevention and treatment of PFD. However, there is a lack of reliable diagnostic devices to evaluate and diagnose regional PFM abnormality. In this work, we developed a multifunctional evaluation technology (MET) based on a novel airbag-type stretchable electrode array probe (ASEA) for the diagnosis of malfunctions of regional PFM. The inflatable ASEA has specifically distributed 32 electrodes along the muscles, and is able to adapt to different human bodies for tight contact with the muscles. These allow synchronous collection of high-quality multi-channel surface electromyography (MC-sEMG) signals, and then are used to diagnose regional PFM malfunctions and evaluate inter-regional correlation. Clinical trial was conducted on 15 postpartum stress urinary incontinence (PSUI) patients and 15 matched asymptomatic women. Results showed that SUI patients responded slowly to the command and have symptoms of muscle strength degeneration. The results were consistent with the relevant clinical manifestations, and proved the reliability of MET for multifunctional PFM evaluation. Furthermore, the MET can diagnose malfunctions of regional PFM, which is inaccessible with existing technology. The results also showed that the dysfunction of PSUI patients is mainly located in iliococcygeus, pubococcygeus, and urethral sphincter regions, and there is a weak correlation between these specific regions and nearby regions. In conclusion, MET provides a point-of-care diagnostic method for abnormal function of regional PFM, which has a potential for the targeted point-to-point electrical stimulation treatment and PFD pathology research.

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Section: Discussionmentioning

confidence: 99%

Multifunctional Evaluation Technology for Diagnosing Malfunctions of Regional Pelvic Floor Muscles Based on Stretchable Electrode Array Probe

et al. 2023

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“…Recent studies have validated the reliability of transvaginal ultrasound in assessing the structure of the levator ani muscles through systematic autopsies. The high resolution and detailed identification ability of the levator ani muscle with ultrasound enable a more precise assessment of the structure and injuries of these muscles [ 6 , 7 ]. Additionally, ultrasound is widely accepted for evaluating myofascial pain, with specific characteristics such as hypoechoic regions (darker grayscale) at the trigger points and increased stiffness in elastography [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring transvaginal sonographic characteristics of the levator ani muscle in women with postpartum pelvic floor myofascial pain

Ye,

Fei,

et al. 2024

BMC Women's Health

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Background Pelvic floor myofascial pain is one of the pelvic floor dysfunction diseases disturbing women after delivery. There is a lack of objective standardization for the diagnosis of pelvic floor myofascial pain due to the various symptoms and the dependence on the palpating evaluation. Ultrasound imaging has the advantages of safety, simplicity, economy and high resolution, which makes it an ideal tool for the assistant diagnosis of pelvic floor myofascial pain and evaluation after treatment. Methods This is a retrospective case-control study including women accepting evaluation of pelvic floor function at 6 weeks to 1 year postpartum. They were divided into pelvic floor myofascial pain group and normal control group. A BCL 10–5 biplane transducer was applied to observed their puborectalis. The length, minimum width, area, deficiency, deficiency length, deficiency width, deficiency area, rate of deficiency area, local thickening,angle between the tendinous arch of levator ani muscle and puborectalis of corresponding puborectalis in different groups were observed and measured. Results A total of 220 postpartum women participated in the study, with 77 in the pelvic floor myofascial pain group and 143 in the normal control group. The Intraclass correlation coefficient value was over 0.750, and Kappa ranged from 0.600 to 0.800. puborectalis deficiency (adjusted odds ratio = 11.625, 95% confidence interval = 4.557–29.658) and focal thickening (adjusted odds ratio = 16.891, 95% confidence interval = 1.819–156.805) were significantly associated with higher odds of having postpartum pelvic floor myofascial pain. Grayscale or the angle between the arch tendineus levator ani and puborectalis measurements on the pain side tended to be smaller than on the non-pain side in patients with unilateral puborectalis or iliococcygeus pain (P < 0.05). Conclusions This study demonstrated that transvaginal ultrasound was a potentially efficient technique for evaluating postpartum pelvic floor myofascial pain due to its ability to assess various sonographic characteristics of the levator ani muscles.

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Ultrasonographic Techniques and Clinical Applications

Wieczorek

Woźniak

Stankiewicz

2020

Pelvic Floor Disorders

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Levator ani defects in patients with stress urinary incontinence: three-dimensional endovaginal ultrasound assessment

Abstract: Patients with SUI have a higher prevalence of no or mild LA defect compared with a moderate or severe LA defect.

Cited by 7 publications

References 30 publications

Multifunctional Evaluation Technology for Diagnosing Malfunctions of Regional Pelvic Floor Muscles Based on Stretchable Electrode Array Probe

Multifunctional Evaluation Technology for Diagnosing Malfunctions of Regional Pelvic Floor Muscles Based on Stretchable Electrode Array Probe

Exploring transvaginal sonographic characteristics of the levator ani muscle in women with postpartum pelvic floor myofascial pain

Ultrasonographic Techniques and Clinical Applications

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