Skip to main content

Endoanal, Endovaginal, and Transperineal Ultrasound

  • Chapter
  • First Online:
Anorectal Physiology

Abstract

Ultrasonography or ultrasound is an imaging method that has great utility for the evaluation of pelvic floor elements, including the anal sphincter muscles and other structures. The development of high-resolution transducers, with higher frequencies and three-dimensional configuration, has enabled the evaluation of the pelvic floor in a static and dynamic way.

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

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Law PJ, Bartram CI. Anal endosonography – technique and normal anatomy. Gastrointest Radiol. 1989;14:349–53.

    CAS  PubMed  Google Scholar 

  2. Rottenberg GT, Williams AB. Endoanal ultrasound. Br J Radiol. 2002;75:482–8.

    CAS  PubMed  Google Scholar 

  3. Williams AB, Bartram CI, Halligan S, et al. Endosonographic anatomy of the normal anal canal compared with endocoil magnetic resonance imaging. Dis Colon Rectum. 2002;45(2):176–83.

    CAS  PubMed  Google Scholar 

  4. Tjandra JJ, Milsom JW, Stolfi VM, et al. Endoluminal ultrasound defines anatomy of the anal canal and pelvic floor. Dis Colon Rectum. 1992;35:465–70.

    CAS  PubMed  Google Scholar 

  5. Frudinger A, Halligan S, Bartram CI, et al. Female anal sphincter: age-related differences in asymptomatic volunteers with high-frequency endoanal US. Radiology. 2002;224(2):417–23.

    PubMed  Google Scholar 

  6. Oliveira L, Wexner SD. Anal incontinence. In: Beck D, Wexner SD, editors. Fundamentals of anorectal surgery. 2nd ed. London: W.B. Saunders; 1999. p. 115–52..

    Google Scholar 

  7. Faridi A, Willis S, Schelzig P, et al. Anal sphincter injury during vaginal delivery – an argument for cesarean section on request? J Perinat Med. 2002;30(5):379–87.

    PubMed  Google Scholar 

  8. Oliveira L, Pfeifer J, Wexner SD. Clinical and physiological outcome of anterior sphincteroplasty. Br J Surg. 1996;83:502–5.

    CAS  PubMed  Google Scholar 

  9. Sentovich SM, Wong WD, Blatchford GJ. Accuracy and reliability of transanal ultrasound for anterior anal sphincter injury. Dis Colon Rectum. 1998;41:1000–4.

    CAS  PubMed  Google Scholar 

  10. Bollard RC, Gardiner A, Lindow S, et al. Normal female anal sphincter: difficulties in interpretation explained. Dis Colon Rectum. 2002;45:171–5.

    CAS  PubMed  Google Scholar 

  11. Ramirez Rodriguez JM, Palacios Fanlo MJ, Artigas Marco C et al. Anal endosonography for the study of anal canal anatomy: normal images and sonographic variants. Ver Esp Enferm Dig 2001; 93(6):364–371.

    Google Scholar 

  12. Guy RJ, Kamm MA, Martin JE. Internal anal sphincter myopathy causing proctalgia fugax and constipation: further clinical and radiological characterization in a patient. Eur J Gastroenterol Hepatol. 1997;9(2):221–4.

    CAS  PubMed  Google Scholar 

  13. Zetterstrom JP, Mellgren A, Madoff RD, et al. Perineal body measurement improves evaluation of anterior sphincter lesions during endoanal ultrasonography. Dis Colon Rectum. 1998;41:705–13.

    CAS  PubMed  Google Scholar 

  14. Deen KI, Kumar D, Williams JG, et al. The prevalence of anal sphincter defects in faecal incontinence: a prospective endosonic study. Gut. 1993;34:685–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Enck P, Heyer T, Gantke B, et al. How reproducible are measures of the anal sphincter muscle diameter by endoanal ultrasound? Am J Gastroenterol. 1997;92(2):293–6.

    CAS  PubMed  Google Scholar 

  16. Buhr HJ, Kroesen AJ. The importance of diagnostics in faecal incontinence. Endosonography. Chirurg. 2003;74(1):4–14.

    CAS  PubMed  Google Scholar 

  17. Rieger NA, Sweeney JL, Hoffmann DC, et al. Investigation of fecal incontinence with endoanal ultrasound. Dis Colon Rectum. 1996;39(8):860–4.

    CAS  PubMed  Google Scholar 

  18. Farouk R, Bartolo DC. The use of endoluminal ultrasound in the assessment of patients with faecal incontinence. J R Coll Surg Edinb. 1994;39(5):312–8.

    CAS  PubMed  Google Scholar 

  19. Karoui S, Savoye-Collet C, Koning E, et al. Prevalence of sphincter defects revealed by sonography in 335 incontinent patients and 115 continent patients. Am J Roentgenol. 1999;173:389–92.

    CAS  Google Scholar 

  20. Stamatiadis A, Konstantinou E, Theodosopoulou E, et al. Frequency of operative trauma to anal sphincters: evaluation with endoanal ultrasound. Gastroenterol Nurs. 2002;25(2):55–9.

    PubMed  Google Scholar 

  21. Engel AF, Kamm MA, Sultan AH, et al. Anterior anal sphincter repair in patients with obstetric trauma. Br J Surg. 1994;81(8):1231–4.

    CAS  PubMed  Google Scholar 

  22. Nielsen MB, Dammegaard L, Pedersen JF. Endosonographic assessment of the anal sphincter after surgical reconstruction. Dis Colon Rectum. 1994;37(5):434–8.

    CAS  PubMed  Google Scholar 

  23. Fleshman JW, Peters WR, Shemesh EI, et al. Anal sphincter reconstruction: anterior overlapping muscle repair. Dis Colon Rectum. 1991;34(9):739–43.

    CAS  PubMed  Google Scholar 

  24. Ternent CA, Shashidharan M, Blatchford GJ, et al. Transanal ultrasound and anorectal physiology findings affecting continence after sphinctero- plasty. Dis Colon Rectum. 1997;40(4):462–7.

    CAS  PubMed  Google Scholar 

  25. Matsuoka H, Mavrantonis C, Wexner SD, et al. Postanal repair for fecal incontinence–is it worthwhile? Dis Colon Rectum. 2000;43(11):1561–7.

    CAS  PubMed  Google Scholar 

  26. Savoye-Collet C, Savoye G, Koning E, Thoumas D, Michot F, Denis P, et al. Anal endosonography after sphincter repair: specific patterns related to clinical outcome. Abdom Imaging. 1999;24(6):569–73.

    CAS  PubMed  Google Scholar 

  27. Tjandra JJ, Milsom JW, Schroeder T, et al. Endoluminal ultrasound is preferable to electromyography in mapping anal sphincteric defects. Dis Colon Rectum. 1993;36(7):689–92.

    CAS  PubMed  Google Scholar 

  28. Enck P, von Giesen HJ, Schäfer A, et al. Comparison of anal sonography with conventional needle electromyography in the evaluation of anal sphincter defects. Am J Gastroenterol. 1996;91(12):2539–43.

    CAS  PubMed  Google Scholar 

  29. Starck M, Bohe M, Valentin L. Results of endosonographic imaging of the anal sphincter 2–7 days after primary repair of third- or fourth-degree obstetric sphincter tears. Ultrasound Obstet Gynecol. 2003;22:609–15.

    CAS  PubMed  Google Scholar 

  30. Sultan AH. Anal incontinence after childbirth. Curr Opin Obstet Gynecol. 1997;9:320–4.

    CAS  PubMed  Google Scholar 

  31. Sultan AH, Kamm MA, Talbot IC, Nicholls RJ, Bartram CI. Anal endosonography for identifying external sphincter defects confirmed histologically. Br J Surg. 1994;81:463–5.

    CAS  PubMed  Google Scholar 

  32. Sultan AH, Johanson RB, Carter JE. Occult anal sphincter trauma following randomized forceps and vacuum delivery. Int J Gynecol Obstet. 1998;61:113–9.

    CAS  Google Scholar 

  33. Norderval S, Markskog A, Røssaak K, Vonen B. Correlation between anal sphincter defects and anal incontinence following obstetric sphincter tears: assessment using scoring systems for sonographic classification of defects. Ultrasound Obstet Gynecol. 2007;31(1):78–84.

    Google Scholar 

  34. Suarez L, Olivares F, Lobo E, et al. Anal endosonography in children with chronic constipation. Pediatr Radiol. 1999;29(1):28–30.

    CAS  PubMed  Google Scholar 

  35. Nielsen MB, Pedersen JF. Changes in the anal sphincter with age. An endosonographic study. Acta Radiol. 1996;37(3 Pt 1):357–61.

    CAS  PubMed  Google Scholar 

  36. Martin JE, Swash M, Kamm MA, et al. Myopathy of internal anal sphincter with polyglucosan inclusions. J Pathol. 1990;161(3):221–6.

    CAS  PubMed  Google Scholar 

  37. Gillick J, Tazawa H, Puri P. Intestinal neuronal dysplasia: results of treatment in 33 patients. J Pediatr Surg. 2001;36(5):777–9.

    CAS  PubMed  Google Scholar 

  38. Marshall M, Halligan S, Fotheringham T, et al. Predictive value of internal anal sphincter thickness for diagnosis of rectal intussusception in patients with solitary rectal ulcer. Br J Surg. 2002;89:1281–5.

    CAS  PubMed  Google Scholar 

  39. Koh CE, Young CJ, Wright CM, et al. The internal anal sphincter in systemic sclerosis. Dis Colon Rectum. 2009;52(2):315–8.

    PubMed  Google Scholar 

  40. Pascual I, García-Olmo D, Martínez-Puente C, et al. Ultrasound findings in spontaneous and postoperative anal pain. Rev Esp Enferm Dig. 2008;100(12):764–7.

    CAS  PubMed  Google Scholar 

  41. Knowles AM, Knowles CH, Scott SM, et al. Effects of age and gender on three-dimensional endoanal ultrasonography measurements: development of normal ranges. Tech Coloproctol. 2008;12(4):323–9.

    CAS  PubMed  Google Scholar 

  42. Lewicky-Gaupp C, Hamilton Q, Ashton-Miller J, et al. Anal sphincter structure and function relationships in aging and fecal incontinence. Am J Obstet Gynecol. 2009;200(5):559.

    PubMed  PubMed Central  Google Scholar 

  43. Kenefick NJ, Vaizey CJ, Malouf AJ, et al. Injectable silicone biomaterial for faecal incontinence due to internal anal sphincter dysfunction. Gut. 2002;51(2):225–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  44. Nygaard IE, Shaw JM. Physical activity and the pelvic floor. Am J Obstet Gynecol. 2016;214(2):164–71.

    PubMed  Google Scholar 

  45. Shobeiri SA, Leclaire E, Nihira MA, et al. Appearance of the levator ani muscle subdivisions in endovaginal three-dimensional ultrasonography. Obstet Gynecol. 2009;114(1):66–72.

    PubMed  Google Scholar 

  46. Santoro GA, Wieczorek AP, Stankiewicz A, et al. High-resolution three-dimensional endovaginal ultrasonography in the assessment of pelvic floor anatomy: a preliminary study. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(10):1213–22.

    PubMed  Google Scholar 

  47. Murad-Regadas SM, Bezerra LR, Silveira CR, et al. Anatomical and functional characteristics of the pelvic floor in nulliparous women submitted to three-dimensional endovaginal ultrasonography: case control study and evaluation of interobserver agreement. Rev Bras Ginecol Obstet. 2013;35(3):123–9.

    PubMed  Google Scholar 

  48. Beer-Gabel M, Teshler M, Barzilai N, Lurie Y, Malnick S, Bass D, Zbar A. Dynamic transperineal ultrasound in the diagnosis of pelvic floor disorders: pilot study. Dis Colon Rectum. 2002;45(2):239–45; discussion 245–8.

    PubMed  Google Scholar 

  49. Kołodziejczak M, Sudoł-Szopińska I, Santoro GA, Bielecki K, Wiączek A. Ultrasonographic evaluation of anal endometriosis: report of four cases. Tech Coloproctol. 2014;18(11):1099–104.

    PubMed  Google Scholar 

  50. Albuquerque A. Endoanal ultrasonography in fecal incontinence: current and future perspectives. World J Gastrointest Endosc. 2015;7(6):575–81.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Oliveira, L.C.C. (2020). Endoanal, Endovaginal, and Transperineal Ultrasound. In: Oliveira, L. (eds) Anorectal Physiology. Springer, Cham. https://doi.org/10.1007/978-3-030-43811-1_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-43811-1_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-43810-4

  • Online ISBN: 978-3-030-43811-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics