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Dynamic translabial ultrasound versus echodefecography combined with the endovaginal approach to assess pelvic floor dysfunctions: How effective are these techniques?

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Abstract

Background

The aim of this study was to evaluate the role of dynamic translabial ultrasound (TLUS) in the assessment of pelvic floor dysfunction and compare the results with echodefecography (EDF) combined with the endovaginal approach.

Methods

Consecutive female patients with pelvic floor dysfunction were eligible. Each patient was assessed with EDF combined with the endovaginal approach and TLUS. The diagnostic accuracy of the TLUS was evaluated using the results of EDF as the standard for comparison.

Results

A total of 42 women were included. Four sphincter defects were identified with both techniques, and EDF clearly showed if the defect was partial or total and additionally identified the pubovisceral muscle defect. There was substantial concordance regarding normal relaxation and anismus. Perfect concordance was found with rectocele and cystocele. The rectocele depth was measured with TLUS and quantified according to the EDF classification. Fair concordance was found for intussusception. There was no correlation between the displacement of the puborectal muscle at maximum straining on EDF with the displacement of the anorectal junction (ARJ), compared at rest with maximal straining on TLUS to determine perineal descent (PD). The mean ARJ displacement was similar in patients with normal and those with excessive PD on TLUS.

Conclusions

Both modalities can be used as a method to assess pelvic floor dysfunction. The EDF using 3D anorectal and endovaginal approaches showed advantages in identification of the anal sphincters and pubodefects (partial or total). There was good correlation between the two techniques, and a TLUS rectocele classification based on size that corresponds to the established classification using EDF was established.

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Authors and Affiliations

  1. Unit of Pelvic Floor and Anorectal Physiology, Department of Surgery, School of Medicine, Clinical Hospital, Federal University of Ceará, Av Pontes Vieira, 2551, Fortaleza, CE, 60130-241, Brazil

    S. M. Murad-Regadas, F. S. P. Regadas & L. B. Veras

  2. Unit of Pelvic Floor and Anorectal Physiology, Clinical Hospital, Federal University of Ceará, Fortaleza, CE, Brazil

    S. M. Murad-Regadas, S. A. Karbage & L. S. Bezerra

  3. Unit of Pelvic Floor and Anorectal Physiology, Department of Colorectal Surgery, Sao Carlos Hospital, Fortaleza, CE, Brazil

    S. M. Murad-Regadas, S. A. Karbage, L. S. Bezerra, A. da Silva Vilarinho, L. B. Borges & F. S. P. Regadas Filho

  4. Department of Gynecology, School of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil

    S. A. Karbage & L. S. Bezerra

Authors
  1. S. M. Murad-Regadas
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  2. S. A. Karbage
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  3. L. S. Bezerra
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  4. F. S. P. Regadas
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  5. A. da Silva Vilarinho
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  6. L. B. Borges
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  7. F. S. P. Regadas Filho
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  8. L. B. Veras
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Corresponding author

Correspondence to S. M. Murad-Regadas.

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The authors declare that they have no conflict of interest.

Ethical approval

The clinical protocol was approved by the Research Ethics Committee of the Walter Cantido University Hospital.

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All patients gave written informed consent.

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Murad-Regadas, S.M., Karbage, S.A., Bezerra, L.S. et al. Dynamic translabial ultrasound versus echodefecography combined with the endovaginal approach to assess pelvic floor dysfunctions: How effective are these techniques?. Tech Coloproctol 21, 555–565 (2017). https://doi.org/10.1007/s10151-017-1658-0

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  • DOI: https://doi.org/10.1007/s10151-017-1658-0

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