Evaluation of Transperineal Ultrasound as A tool for Assessment of Women with Pelvic Floor Dysfunctions

Background: Female pelvic floor dysfunction (FPFD) is a common gynecological disorder. Several methods are used to assess the condition. However, there is no consensus on the standard technique. This study aimed to address the role of 2D and 3D trans-perineal ultrasound (TPUS) in symptomatic pelvic muscle dysfunction and correlate the findings with clinical data. Patients and methods: This study included 70 women with symptomatic pelvic muscle dysfunction women. They were submitted to standard clinical evaluation. Then, 2D and 3D trans-perineal ultrasound (TPUS) was performed for all of them and results were correlated with the clinical data. Results: Levator ani muscle avulsion was recorded for 55.7%. Levator hiatal antero-posterior (LHap) diameter was increased in poor (UpfmC) than normal (NpfmC) groups at rest (77.97±4.33 mm vs. 64.9±5.03 mm), in Valsalva (86.3±3.7 mm vs. 69.7±5.2 mm), and at maximum contraction (68.32±4.4 mm vs. 55.03±4.15 mm). There was negative correlation between Modified Oxford Score (MOS) and parity (r=-0.607) and LHap diameter, levator urethral gap (LUG) at right and left sides side (r=-0.760, -0.805). Additionally, there was negative correlation between MOS and hypertension (r=-0.268), chronic constipation (r=-0.390), and levator avulsion (r=-0.846). However, significant positive correlation was detected between MOS and mode of delivery (r=0.310). A significant correlation was detected between LHap diameter at rest and parity (r=0.286), LUG at right side (r=0.746), at left side (r=0.742), chronic constipation (r=0.251), and the presence of levator avulsion (r=0.8371). However, there was a significant negative correlation between LHap diameter at rest and mode of delivery (r=-0.236). Conclusion: Transperineal ultrasound reflected the pelvic floor muscle function and correlated with palpation to evaluate muscle contractility. It can be used as ad adjunct tool to improve the accuracy of diagnosis of pelvic floor disorders and to help in management planning.