Current capabilities of ultrasound diagnosis of pelvic floor dysfunction

Sencha A.N., Apolikhina I.A., Teterina T.A., Fedotkina E.P.

1) Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow, Russia; 2) I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Department of Obstetrics, Gynecology, Perinatology, and Reproductology, Moscow, Russia
Pelvic floor dysfunction is a complex of abnormal functioning of the pelvic floor muscles and ligamentous apparatus, which leads to disruption of work and descent/prolapse of the pelvic organs. Damages to the support structures of the pelvic floor can contribute to pelvic floor dysfunction. The prevalence of genital prolapse increases with age. According to demographic indicators, there is an increase in women’s life expectancy, including the duration of the menopause period in the female population, which is associated with a decrease in estrogen levels and a worse connective tissue quality, which contributes to the formation of pelvic floor dysfunction. Consequently, genital prolapse is becoming more common. The suggestions have been made that the incidence of genital prolapse will double in the next 30 years. Currently, the problem of genital prolapse is called a hidden epidemic.
Among the available diagnostic methods, such as X-rays, computed tomography, magnetic resonance imaging (MRI), and echography, the latter absolutely has an advantage for imaging the pelvic floor. This technique is safe, simple, cheap, readily available, and provides high spatial and temporal resolution.
The paper presents the possibilities of modern ultrasound multiparametric visualization of pelvic floor structures. In connection with the improvement of three-dimensional ultrasound technologies, volumetric ultrasound has become a new tool to diagnose the status of the pelvic floor. 3D imaging allows determining the axial plane with good spatial and temporal resolution. Multislice computed tomography, like MRI, promotes layer-by-layer assessment of all structures and differentiation of microtraumas of the pelvic floor muscles.
Conclusion: Ultrasound imaging has become an important tool not only for the timely diagnosis of pelvic floor dysfunction, but also for the prevention of genital prolapse.

Keywords

pelvic floor
pelvic organ prolapse
urinary incontinence
MRI of the pelvic organs
pelvic floor ultrasound
3D ultrasound
multislice

References

1. Lammers K., Futterer J.J., Prokop M., Vierhout M.E., Kluivers K.B. Diagnosing pubovisceral avulsions: a systematic review of the clinical relevance of a prevalent anatomical defect. Int. Urogynecol. J. 2012;23(12): 1653-64. https://dx.doi.org/10.1007/s00192-012-1805-0.

2. Dietz H.P. Pelvic floor ultrasound in prolapse: what’s in it for the surgeon? Int. Urogynecol. J. 2011; 22(10): 1221-32. https://dx.doi.org/10.1007/ s00192-011-1459-3.

3. Notte K.J., Weemhoff M., Kluivers K.B., Schweitzer K.J., Mulder F., Stoker J. et al. Protocol for translabial 3D-ultrasonography or diagnosing levator defects (TRUDIL): a multicenter cohort study for estimating the diagnostic accuracy of translabial 3D-ultrasonography of the pelvic floor as compared to MR imaging. BMC Women’s Health. 2011; 11: 23. https://dx.doi.org/10.1186/ 1472-6874-11-23.

4. Чечнева М.А., Буянова С.Н., Попов А.А., Краснопольская И.В. Ультразвуковая диагностика пролапса гениталий и недержания мочи у женщин. М.: МЕДпресс-информ; 2016. 136с. [Chechneva M.A., Buyanova S.N., Popov A.A., Krasnopolskaya I.V. Ultrasound diagnosis of genital prolapse and urinary incontinence in women. M.: MEDpress-inform, 2016. 136 p. (in Russian)].

5. Dietz H.P. Pelvic floor ultrasound. Atlas and textbook. Springwood; 2016. 125p.

6. Dietz H.P. Pelvic floor ultrasound: a review. Clin. Obstet. Gynecol. 2017; 60(1): 58-81. https://dx.doi.org/10.1097/GRF.0000000000000264.

7. Vellucci F., Regini C., Barbanti C., Luisi S. Pelvic floor evaluation with transperineal ultrasound: a new approach. Minerva Ginecol. 2018; 70(1): 58-68. https://dx.doi.org/10.23736/S0026-4784.17.04121-1.

8. Pham T.X., Quiroz L.H. Ultrasonographic imaging of the pelvic Ffoor. Obstet. Gynecol. Clin. North. Am. 2021; 48(3): 617-37. https://dx.doi.org/10.1016/ j.ogc.2021.05.014.

9. Краснопольская И.В. Дисфункция тазового дна у женщин: клиника, диаг-ностика, принципы лечения. Акушерство и гинекология. 2018; 2: 82-6. [Krasnopolskaya I.V. Pelvic floor dysfunction in women: clinical presentation, diagnosis, and principles of treatment. Obstetrics and Gynecology. 2018; 2: 82-6. (in Russian)]. https://dx.doi.org/10.18565/aig.2018.2.82-86.

10. Крутова В.А., Надточий А.В., Наумова Н.В., Болдовская Е.А. Мультипараметрическая ультразвуковая оценка тазового дна у пациенток с генитальным пролапсом после применения биологической обратной связи и электроимпульсной стимуляции. Акушерство и гинекология. 2020; 10: 156-61. [Krutova V.A., Nadtochiy A.V., Naumova N.V., Boldovskaya E.A. Multiparametric ultrasound assessment of the pelvic floor in patients with genital prolapse after biological feedback and electric pulse stimulation. Obstetrics and Gynecology. 2020; 10: 156-61. (in Russian)]. https://dx.doi.org/10.18565/aig.2020.10.156-161.

11. Аполихина И.А., Чочуева А.С., Гус А.И., Игнатьева А.А., Бычкова А.Е. Современные подходы к диагностике повреждений структур тазового дна в родах. Акушерство и гинекология. 2018; 7: 20-5. [Apolikhina I.A., Chochueva A.S., Gus A.I., Ignatyeva A.A., Bychkona A.E. Current approaches to diagnosing damages to the pelvic floor structures during childbirth. Obstetrics and Gynecology. 2018; 7: 20-5. (in Russian)]. https://dx.doi.org/10.18565/ aig.2018.7.20-25.

Received 21.12.2021

Accepted 24.02.2022

About the Authors

Alexander N. Sencha, Dr. Med. Sci., Head of the Visual Diagnostic Department, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, +7(968)844-90-15, senchavyatka@mail.ru, 4 Akademika Oparina str., Moscow, 117997, Russian Federation.
Inna A. Apolikhina, Dr. Med. Sci., Professor, Head of Department of Aesthetic Gynecology and Rehabilitation, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, 4 Akademika Oparina str., Moscow, 117997, Russian Federation; I.M. Sechenov
First Moscow State Medical University, 8-2 Trubetskaya str., Moscow, 119991, Russian Federation, +7(495)735-10-55, apolikhina@inbox.ru
Tatiana A. Teterina, PhD, obstetrician-gynecologist at the Department of Aesthetic Gynecology and Rehabilitation, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, +7(963)961-67-44, palpebra@inbox.ru,
4 Akademika Oparina str., Moscow, 117997, Russian Federation.
Elena P. Fedotkina, PhD, Sonologist at the Visual Diagnostic Department, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, +7(495)735-10-55, epf@yandex.ru, 4 Akademika Oparina str., Moscow, 117997, Russian Federation.

Authors’ contributions: Teterina T.A., Sencha A.N. - selection of literature for data analysis; Teterina T.A., Fedotkina E.P. - writing the text; Apolikhina I.A., Sencha A.N., Fedotkina E.P. - editing.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The investigation has not been sponsored.
For citation: Sencha A.N., Apolikhina I.A., Teterina T.A., Fedotkina E.P. Current capabilities of ultrasound diagnosis of pelvic floor dysfunction.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 3: 138-147 (in Russian)
https://dx.doi.org/10.18565/aig.2022.3.138-147

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