Quantification of pelvic floor muscle strength in female urinary incontinence: A systematic review and comparison of contemporary methodologies

Abstract

Technical refinements in both direct and indirect instrumentation for PFM strength measurement are allowing for sensitivity. However, the most common methods of quantification remain digital palpation and perineometry; techniques that pose limitations and yield subjective or indirect measures of muscular strength. Dynamometry has potential as an accurate and sensitive tool, but is limited by inability to assess PFM strength during dynamic movements.

Evaluating Z Scores to Quantify Levator Hiatal Distensibility by 3‐Dimensional Ultrasonography in Nulliparas and Women With Pelvic Organ Prolapse

“…The levator hiatus is defined as the space enclosed by the levator ani muscle, which is the most important supporting tissue of the pelvic floor. To some extent, the levator hiatal dimensions reflect the biometric characteristics of the levator ani muscle . Hiatal ballooning has been popularly expressed as percentages or absolute values of the changes in the hiatal area during the Valsalva maneuver .…”

“…To some extent, the levator hiatal dimensions reflect the biometric characteristics of the levator ani muscle. 1,2,15,16 Hiatal ballooning has been popularly expressed as percentages or absolute values of the changes in the hiatal area during the Valsalva maneuver. 8,17 The hiatal area is a repeatable diagnostic parameter.…”

Ultrasound assessment of pelvic floor muscle contraction: reliability and development of an ultrasound‐based contraction scale

“…The strength of correlation (r S ) between ultrasound measurements and MOS score was 0.52 for 2D AP diameter, 0.62 for 3D AP diameter and 0.47 for hiatal area (P < 0.001 for all). On the ultrasound contraction scale, proportional change in 2D levator 126 Nyhus et al hiatal AP diameter of < 1% corresponds to absent,[2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Conclusions Ultrasound seems to be an objective and reliable method for evaluation of pelvic floor muscle contraction. Proportional change in 2D levator hiatal AP diameter had the highest ICC and moderate correlation with MOS score assessed by vaginal palpation, and we constructed an ultrasound scale for assessment of pelvic floor muscle contraction based on this measure.…”

Practical guide to dynamic pelvic floor MRI

“…Underestimation of pelvic organ prolapse may lead to an incorrect choice of treatment, contributing to high recurrence rates . Imaging has become an important complementary tool in the assessment of pelvic floor disorders, and dynamic pelvic floor magnetic resonance imaging (MRI), or MR defecography, has evolved as one of the essential imaging techniques . MRI can simultaneously noninvasively evaluate all pelvic floor compartments, and provide information about muscles and ligaments with great contrast resolution, without the use of ionizing radiation and with minimal patient discomfort .…”

“…7,8 Imaging has become an important complementary tool in the assessment of pelvic floor disorders, and dynamic pelvic floor magnetic resonance imaging (MRI), or MR defecography, has evolved as one of the essential imaging techniques. [9][10][11] MRI can simultaneously noninvasively evaluate all pelvic floor compartments, and provide information about muscles and ligaments with great contrast resolution, without the use of ionizing radiation and with minimal patient discomfort. 12 While anterior and middle compartment causes of pelvic floor dysfunction can often be detected by physical exam, posterior compartment pathology such as enteroceles, peritoneoceles, and rectorectal intussusceptions are commonly not detected by physical exam but are well visualized by MRI.…”