Skip to main content

Advertisement

SpringerLink
Log in

Updated recommendations on ultrasonography in urogynecology

  • Review Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Ultrasound is a supplementary, indispensable diagnostic procedure in urogynecology; perineal, introital, and endoanal ultrasound are the most recommended techniques. The position and mobility of the bladder neck can be demonstrated. In patients undergoing diagnostic work-up for urge symptoms, ultrasound occasionally demonstrates urethral diverticula, leiomyomas, and cysts in the vaginal wall. These findings will lead to further diagnostic assessment. The same applies to the demonstration of bladder diverticula, foreign bodies in the bladder, and bullous edema. With endoanal ultrasound, different parts of the sphincter ani muscle can be evaluated. Recommendations for the standardized use of urogenital ultrasound are given.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Koelbl H, Hanzal E (1995) Imaging of the lower urinary tract. Curr Opin Obstet Gynecol 7:382–385

    CAS  PubMed  Google Scholar 

  2. Bernaschek G (1989) Empfehlungen für eine einheitliche endosonographische Dokumentation in Geburtshilfe und Gynäkologie. Ultraschall Klin Prax 4:45–48

    Google Scholar 

  3. Merz E (1991) Standardisierung der Bilddarstellung bei der transvaginalen Sonographie. Gynäkol Geburtsh 1:37–38

  4. Schaer GN, Koechli OR, Schuessler B, Haller U (1995) Perineal ultrasound for evaluating the bladder neck in urinary stress incontinence. Obstet Gynecol 85:224

    Article  Google Scholar 

  5. Peschers UM, Vodusek DB, Fanger G, Schaer GN, DeLancey JO, Schuessler B (2001) Pelvic muscle activity in nulliparous volunteers. Neurourol Urodyn 20:269–275

    Article  CAS  PubMed  Google Scholar 

  6. Pregazzi R, Sartore A, Bortoli P, Grimaldi E, Troiano L, Guaschino S (2002) Perineal ultrasound evaluation of urethral angle and bladder neck mobility in women with stress urinary incontinence. BJOG 109:821–827

    PubMed  Google Scholar 

  7. Bader W, Degenhardt F, Kauffels W, Nehls K, Schneider J (1995) Sonomorphologische Parameter der weiblichen Stressharninkontinenz. Ultraschall Med 16:180–185

    CAS  PubMed  Google Scholar 

  8. Schwenke A, Fischer W (1994) Urogenitalsonographie bei weiblicher Harninkontinenz. Gynäkol Prax 16:683–694

    Google Scholar 

  9. Viereck V, Pauer HU, Bader W, Lange R, Viereck N, Emons G et al (2003) Ultrasound imaging of the lower urinary tract in women before and after colposuspension: a 6-month follow-up. Ultraschall Med 24:340–344

    Article  CAS  PubMed  Google Scholar 

  10. Viereck V, Pauer HU, Oppermann M, Hilgers R, Gauruder-Burmester A, Lange R et al (2004) Introital ultrasound of the lower genital tract before and after colposuspension: a four-year objective follow-up. Ultrasound Obstet Gynecol 23:277–283

    Article  CAS  PubMed  Google Scholar 

  11. Dietz HP, Clarke B (2001) The influence of posture on perineal ultrasound imaging parameters. Int Urogynecol J Pelvic Floor Dysfunct 12:104–106

    CAS  PubMed  Google Scholar 

  12. Schaer GN, Koechli OR, Schuessler B, Haller U (1996) Perineal ultrasound: determination of reliable examination procedures. Ultrasound Obstet Gynecol 7:347–352

    Article  CAS  PubMed  Google Scholar 

  13. Mouritsen L, Bach P (1994) Ultrasonic evaluation of bladder neck position and mobility: the influence of urethral catheter, bladder volume, and body position. Neurourol Urodyn 13:637–646

    CAS  PubMed  Google Scholar 

  14. Dietz HP, Wilson PD (1999) The influence of bladder volume on the position and mobility of the urethrovesical junction. Int Urogynecol J Pelvic Floor Dysfunct 10:3–6

    CAS  PubMed  Google Scholar 

  15. Peschers UM, Gingelmaier A, Jundt K, Leib B, Dimpfl T (2001) Evaluation of pelvic floor muscle strength using four different techniques. Int Urogynecol J Pelvic Floor Dysfunct 12:27–30

    Article  CAS  PubMed  Google Scholar 

  16. Dietz HP, Wilson PD, Clarke B (2001) The use of perineal ultrasound to quantify levator activity and teach pelvic floor muscle exercises. Int Urogynecol J Pelvic Floor Dysfunct 12:166–168

    Article  CAS  PubMed  Google Scholar 

  17. Bo K, Sherburn M, Allen T (2003) Transabdominal ultrasound measurement of pelvic floor muscle activity when activated directly or via a transversus abdominis muscle contraction. Neurourol Urodyn 22:582–588

    Article  PubMed  Google Scholar 

  18. Schaer GN, Perucchini D, Munz E, Peschers U, Koechli OR, DeLancey JO (1999) Sonographic evaluation of the bladder neck in continent and stress-incontinent women. Obstet Gynecol 93:412–416

    Article  CAS  PubMed  Google Scholar 

  19. Dietz HP, Haylen BT, Broome J (2001) Ultrasound in the quantification of female pelvic organ prolapse. Ultrasound Obstet Gynecol 18:511–514

    Article  CAS  PubMed  Google Scholar 

  20. Nguyen JK, Hall CD, Taber E, Bhatia NN (2000) Sonographic diagnosis of paravaginal defects: a standardized technique. Int Urogynecol J Pelvic Floor Dysfunction 11:341–345

    Article  CAS  Google Scholar 

  21. Martan A, Masata J, Halaska M, Otcenasek M, Svabik K (2002) Ultrasound imaging of paravaginal defects in women with stress incontinence before and after paravaginal defect repair. Ultrasound Obstet Gynecol 19:496–500

    Article  CAS  PubMed  Google Scholar 

  22. Tunn R, Petri E (2003) Introital and transvaginal ultrasound as the main tool in the assessment of urogenital and pelvic floor dysfunction: an imaging panel and practical approach. Ultrasound Obstet Gynecol 22:205–213

    Article  CAS  PubMed  Google Scholar 

  23. Khullar V, Salvatore S, Cardozo L, Bourne TH, Abbott D, Kelleher CJ (1994) A novel technique for measuring bladder wall thickness in women using transvaginal ultrasound. Ultrasound Obstet Gynecol 3:220–223

    Article  Google Scholar 

  24. Kociszewski J, Bagci S (2003) TVT—Sonographische Beobachtungen im Hinblick auf die korrekte Lage und Funktion des TVT-Bandes unter Berücksichtigung der individuellen Urethralänge. Geburtshilfe Frauenheilkund 63:640–647

    Article  Google Scholar 

  25. Dietz HP, Wilson PD, Clarke B, Haylen BT (2001) Irritative symptoms after colposuspension: are they due to distortion or overelevation of the anterior vaginal wall and trigone? Int Urogynecol J Pelvic Floor Dysfunct 12:232–235

    Article  CAS  PubMed  Google Scholar 

  26. Martan A, Masata J, Halaska M, Voigt R (2001) Ultrasound imaging of the lower urinary system in women after Burch colposuspension. Ultrasound Obstet Gynecol 17:58–64

    Article  CAS  PubMed  Google Scholar 

  27. Buhr HJ, Kroesen AJ (2003) The importance of diagnostics in fecal incontinence endosonography (in German). Chirurg 74:4–14

    Article  CAS  PubMed  Google Scholar 

  28. Kumar A, Scholefield JH (2000) Endosonography of the anal canal and rectum. World J Surg 24:208–215

    Article  CAS  PubMed  Google Scholar 

  29. Nielsen MB (1998) Endosonography of the anal sphincter muscles in healthy volunteers and in patients with defecation disorders. Acta Radiol 416 [Suppl]:1–21

    Google Scholar 

  30. Rottenberg GT, Williams AB (2002) Endoanal ultrasound. Br J Radiol 75:482–488

    CAS  PubMed  Google Scholar 

  31. Schafer R, Heyer T, Gantke B, Schafer A, Frieling T, Haussinger D et al (1997) Anal endosonography and manometry: comparison in patients with defecation problems. Dis Colon Rectum 40:293–297

    CAS  PubMed  Google Scholar 

  32. Soffer EE, Hull T (2000) Fecal incontinence: a practical approach to evaluation and treatment. Am J Gastroenterol 95:1873–1880

    CAS  PubMed  Google Scholar 

  33. Sultan AH, Loder PB, Bartram CI, Kamm MA, Hudson CN (1994) Vaginal endosonography. New approach to image the undisturbed anal sphincter. Dis Colon Rectum 37:1296–1299

    CAS  PubMed  Google Scholar 

  34. Sandridge DA, Thorp JM (1995) Vaginal endosonography in the assessment of the anorectum. Obstet Gynecol 86:1007–1009

    Article  CAS  PubMed  Google Scholar 

  35. Peschers UM, DeLancey JOL, Schaer GN, Schuessler B (1997) Exoanal ultrasound of the anal sphincter: normal anatomy and sphincter defects. Br J Obstet Gynaecol 104:999–1003

    CAS  PubMed  Google Scholar 

  36. Sultan AH, Kamm MA, Talbot IC, Nicholls RJ, Bartram CI (1994) Anal endosonography for identifying external sphincter defects confirmed histologically. Br J Surg 81:463–465

    CAS  PubMed  Google Scholar 

  37. Goode PS, Locher JL, Bryant RL, Roth DL, Burgio KL (2000) Measurement of postvoid residual urine with portable transabdominal bladder ultrasound scanner and urethral catheterization. Int Urogynecol J Pelvic Floor Dysfunct 11:296–300

    Article  CAS  PubMed  Google Scholar 

  38. Haylen BT (1989) Verification of the accuracy and range of transvaginal ultrasound in measuring bladder volumes in women. Br J Urol 64:350–352

    CAS  PubMed  Google Scholar 

  39. Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Association of Urogynecology and Pelvic Floor Repair, Germany

    R. Tunn, U. Peschers, W. Bader, A. Gauruder, H. Koelbl, E. Petri & V. Viereck

  2. Association of Urogynecology, Switzerland

    G. Schaer, D. Perucchini & B. Schuessler

  3. Association of Urogynecology and Reconstructive Pelvic Floor Surgery, Austria

    E. Hanzal, D. Koelle & P. Riss

  4. Department of Obstetrics and Gynecology, Amperkliniken, Konrad-Adenauer-Str. 30, 85221, Dachau, Germany

    U. Peschers

Authors
  1. R. Tunn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Schaer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. U. Peschers
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. W. Bader
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Gauruder
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. E. Hanzal
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. H. Koelbl
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. D. Koelle
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. D. Perucchini
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. E. Petri
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. P. Riss
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. B. Schuessler
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. V. Viereck
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to U. Peschers.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tunn, R., Schaer, G., Peschers, U. et al. Updated recommendations on ultrasonography in urogynecology. Int Urogynecol J 16, 236–241 (2005). https://doi.org/10.1007/s00192-004-1228-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-004-1228-7

Keywords

Search

Navigation