Particularities of the anterior compartment of the pelvic floor in women with urinary incontinence, revealed by transperineal ultrasound

M. Rada, R. Ciortea, A. Măluțan, M. Oancea, R. M. Hognogi, C. Bucuri, C. Berceanu, D. Mihu

Abstract: Urinary incontinence (UI) represents a condition that, although not vital, has a significant impact that can interfere with the quality of life in a meaningful way for many women, its overall prevalence being of approximately 40%. Since 1920, urogynecologists showed an increasing interest in imaging techniques of the pelvic floor, ultrasound being the method of examination most frequently used with benefits that result from easy accessibility and reduced costs. At the beginning, B-mode ultrasound via transvaginal or transperineal route, was used to describe the urinary bladder and the anterior compartment and only later, the other pelvic compartments. Pelvic floor dysfunctions include several conditions among which UI. The main indications for transperineal ultrasound are: recurrent urinary tract infections, urgency-, frequency-, stress-UI, dysuria, prolapse of pelvic organs, dyspareunia, fecal incontinence, pelvic masses. This method proves its utility in assessing parameters like: residual urine, detrusor wall thickness, mobility of the bladder neck, anterior and posterior urethrovesical angle, urethral integrity. Stress UI may be highlighted by Color Doppler. Studying the pelvic floor during contractions or Valsalva maneuvre allows the assessment of the functional anatomy, keypoint for understanding the UI pathophysiology. The assessment of these specific objective and reproducible parameters is complementary to the diagnosis of UI and puts several therapeutic options in a different light. The progress in imaging permanently contributes to the improvement of therapeutic management either refining existing techniques or supporting the development of new procedures in urogynecology.
DOI:10.18643/gieu.2018.81

Keywords: urinary incontinence, pelvic floor imaging, transperineal ultrasound.