The assessment of levator trauma: A comparison between palpation and 4D pelvic floor ultrasound

Dietz, Hans Peter; Hyland, Gail; Hay‐Smith, Jean

doi:10.1002/nau.20250

Cited by 77 publications

(84 citation statements)

References 19 publications

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“…The authors found poor agreement between the two methods and concluded that imaging has a higher reliability than vaginal palpation, even when performed by a trained and experienced physiotherapist. 32 Further studies using perineometry to evaluate the PFM are required to avoid capturing the action of the other muscle groups that form the wall of the abdominopelvic cavity, 33 because an increase in abdominal pressure will affect the urethral, vaginal and rectal pressures. 34 However, Perschers et al assessed the effect of contraction of the abdominal muscles concomitant with the pelvic floor and reported no significant increase in readings during digital palpation, perineometry, electromyography or ultrasound.…”

Section: Baseline Characteristicsmentioning

confidence: 99%

Correlation between maximum voluntary contraction and endurance measured by digital palpation and manometry: An observational study

Fitz

Stüpp

Costa

et al. 2016

Rev. Assoc. Med. Bras.

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Correlation between maximum voluntary ContraCtion and enduranCe measured by digital palpation and manometry: an observational study rev assoC med bras 2016; 62 (7) Introduction: Digital palpation and manometry are methods that can provide information regarding maximum voluntary contraction (MVC) and endurance of the pelvic floor muscles (PFM), and a strong correlation between these variables can be expected. Objective: To investigate the correlation between MVC and endurance, measured by digital palpation and manometry. Method: Forty-two women, with mean age of 58.1 years (±10.2), and predominant symptoms of stress urinary incontinence (SUI), were included. Examination was firstly conducted by digital palpation and subsequently using a Peritron manometer. MVC was measured using a 0-5 score, based on the Oxford Grading Scale. Endurance was assessed based on the PERFECT scheme. Results:We found a significant positive correlation between the MVC measured by digital palpation and the peak manometric pressure (r=0.579, p<0.001), and between the measurements of the endurance by Peritron manometer and the PERFECT assessment scheme (r=0.559, p<0.001). Conclusion:Our results revealed a positive and significant correlation between the capacity and maintenance of PFM contraction using digital and manometer evaluations in women with predominant symptoms of SUI.

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Section: Baseline Characteristicsmentioning

confidence: 99%

Correlation between maximum voluntary contraction and endurance measured by digital palpation and manometry: An observational study

Fitz

Stüpp

Costa

et al. 2016

Rev. Assoc. Med. Bras.

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“…Furthermore, transabdominal ultrasound imaging has been found to be more sensitive than digital palpation for the detection of an elevating pelvic floor muscle contraction. 31 In a study by Dietz et al, 23 4-dimensional transperineal ultrasound imaging (eg, real-time 3-dimensional imaging) was found to be more sensitive for detection of defects in the levator ani than digital palpation. Although asymmetries of the bladder base have been observed using conventional 2-dimensional transabdominal ultrasound imaging, there is a need for further studies that correlate…”

Section: Qualitative Evaluation T He Use Of Ultrasound Imagingmentioning

confidence: 99%

Rehabilitative Ultrasound Imaging of Pelvic Floor Muscle Function

Whittaker¹,

Thompson²,

Teyhen³

et al. 2007

J Orthop Sports Phys Ther

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found that 78% of women with LBP report concurrent UI. As such, there is a need for physical therapists to have access to tools that accurately evaluate the various aspects of pelvic floor muscle function (elevating and occlusion functions, as well as neuromuscular control, strength, and endurance) both in laboratory and clinical environments.Ultrasound imaging is a potential tool that has been used to evaluate the morphology 7,52 and certain components of the function 24,27,67,81,82,86 of these muscles. Specifically, ultrasound imaging has been shown to be more specific than intravaginal palpation for measurement of the lifting action of the pelvic floor muscles on the bladder neck 31 and base, 20,31 and it provides information about the supporting function of the pelvic floor muscles during various maneuvers. 20,57,85 As the use of rehabilitative ultrasound imaging for assessment of pelvic floor muscles function is a relatively new procedure, the goal of this commentary i t is well accepted that the pelvic floor muscles, specifically the levator ani, provide an important contribution to the continence mechanism.17 is to provide an understanding of current applications, the available quantitative and qualitative information, the associated limitations, and to show how rehabilitative ultrasound imaging can be incorporated as a form of biofeedback during rehabilitation. Furthermore, as the compilation and comparison of data depends on consistency of measurement techniques, this commentary highlights considerations for measurement accuracy and interpretation and provides generic guidelines for future investigation based upon international consensus. 80QuantitatiVe eVaLuation u ltrasound imaging has been used to measure the morphology 7,52 of the pelvic floor muscles. It has also been used to measure the impact of pelvic floor muscle contraction or increase in intra-abdominal pressure (straining, cough, sneeze, or leg-raising task) on the bladder from a variety of approaches (transperineal and transabdominal; Figure 1), planes (sagittal and transverse), and positions. 6,22,27,57,61,67,76,83,84,96 The transperineal approach (placement of the ultrasound transducer in a sagittal plane along the midline of the perineum) is considered advantageous to the transabdominal approach, as both the pubic symphysis and the proximal junction of the bladder neck and urethra are included within the field of view and can serve

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“…Easy imaging of pelvic floor seems to be very important in pelvic floor disorders, since about 10% of females with pelvic prolapse have structural defects of the levator ani that cannot be discovered through a physical examination (23,24).…”

Section: Ultrasonografia 3d/4dmentioning

confidence: 99%

“…Lo stato funzionale del pavimento pelvico è un elemento di grande importanza, poiché circa il 10% delle pazienti con prolasso presenta difetti strutturali dell'elevatore dell'ano che sono mal evidenziabili con il PC test (23,24).…”

Section: Advanced Diagnostic Testing For Female Pelvic Floor Dysfunctunclassified

Advanced Diagnostic Testing for Female Pelvic Floor Dysfunctions

Vignoli¹

2010

UIJ

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SUMMARYThe word "pelvic floor dysfunction" has different meanings in different specialties, i.e. radiology, urology, gynaecology, coloproctology. Despite the fact that the concept of perineology is not exactly new, most clinicians have only slowly adapted their practice to this transversal view. The multidisciplinary approach (several specialists dealing with various pelvic floor problems) still prevails over the interdisciplinary one (one specialist explaining what is happening) with several problems in the choice of therapeutic strategies. Obviously, the interdisciplinary approach requires a wide knowledge of the principles and techniques of each specialty. This monographic issue reviews advanced diagnostic testing for female pelvic floor dysfunctions from the perspective of a single specialist, namely a urologist. SOMMARIOIl termine "disfunzione pelvica" riveste un diverso significato nelle diverse specialità. Nonostante, infatti, il concetto di approccio multidisciplinare alle problematiche del pavimento pelvico non sia propriamente nuovo, i clinici si sono dimostrati lenti nell'adattare la propria pratica ad una visione trasversale del problema. L'alternativa alla multidisciplinarietà è l'interdisciplinarietà, nella quale un singolo specialista prende in carico il paziente esaminandolo sotto tutti i punti di vista. È intuitivo che per un simile approccio non si possa prescindere da una conoscenza specifica del bagaglio culturale di ogni singola specialità. Questo numero monografico rappresenta un tentativo di approccio globale alle disfunzioni del pavimento pelvico da parte di un singolo specialista, urologo nella fattispecie.

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The assessment of levator trauma: A comparison between palpation and 4D pelvic floor ultrasound

Abstract: Palpation of the pubovisceral muscle correlates poorly with 3D/4D pelvic floor ultrasound imaging for the assessment of muscular defects.

Cited by 77 publications

References 19 publications

Correlation between maximum voluntary contraction and endurance measured by digital palpation and manometry: An observational study

Correlation between maximum voluntary contraction and endurance measured by digital palpation and manometry: An observational study

Rehabilitative Ultrasound Imaging of Pelvic Floor Muscle Function

Advanced Diagnostic Testing for Female Pelvic Floor Dysfunctions

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