AIUM/IUGA Practice Parameter for the Performance of Urogynecological Ultrasound Examinations: Developed in Collaboration with the ACR, the AUGS, the AUA, and the SRU

doi:10.1002/jum.14953

Cited by 45 publications

(12 citation statements)

References 54 publications

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“…1 ). Bladder neck descent (BND), bladder neck position at the maximal Valsalva maneuver (BNP), urethral rotation angle, and the retro-vesical angle were measured according to the American Institute of Ultrasound in Medicine (AIUM)/International Urogynecological Association (IUGA) practice parameter [ 8 ].…”

Section: Methodsmentioning

confidence: 99%

Urethral configuration and mobility during urine leaking described using real-time transperineal ultrasonography

et al. 2022

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Objectives: To explore the differences in the bladder neck configuration and segmental urethral mobility in the cough stress test (CST) in supine and standing positions between women with and without stress urinary incontinence (SUI). Methods:We had a prospective study of 100 controlled women and 100 incontinent women who had a CST with TPUS. The bladder neck configuration and urethral mobility were described by urethral funneling, bladder neck descent (BND), retrovesical angle (RVA), urethral rotation angle, and urethral mobility of six points along the urethra (Vectors 1 to 6). The two groups' ultrasound findings in the two positions were compared.Results: Valid data were collected from 78 controlled women and 90 women with SUI. Significant differences were found in age and BMI (p < 0.01) between the two groups. Urethral funneling was found in 33 women (36.7%) with SUI and 5 continent women (6.4%) and altered little in the standing position. In the standing position, the mean RVA was significantly increased (160° to 179°, p<0.001) in the SUI group; The mean vector of points 1 to 6 was significantly increased in the control group (all p < 0.001). The RVA, BND, and Vectors 1 to 4 were significantly greater (all p<= 0.01) in women with SUI than without, in both positions.Conclusions: Urethral funneling was an intrinsic anatomical characteristic relative to SUI. Weak upper-and mid-urethral support and an unstable connection between the trigone and proximal urethra were the anatomical signs for SUI.

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Section: Methodsmentioning

confidence: 99%

Urethral configuration and mobility during urine leaking described using real-time transperineal ultrasonography

et al. 2022

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“…Ultrasound imaging provides a dynamic, 'bed-side', nonionising tool to image a wide range of tissues and organ systems, including the lumbopelvic region [5]. Whilst ultrasound imaging would historically be performed by radiologists or career sonographers within an imaging department, the application of this modality by assessing and treating clinicians (Point of care ultrasound; PoCUS) is an area of rapid expansion [6].…”

Section: Point Of Care Ultrasound In Pelvic Healthmentioning

confidence: 99%

“…To contextualise the use of PoCUS by physiotherapists in PHCPs, Table 1 draws upon previous publications in the area [1,5,8,[11][12][13] to present a range of pelvic health-related clinical presentations which have been grouped together (in column 1) from a physiotherapy perspective according to commonalities of pathophysiology, anatomy or manifestation. Column 2 summarises the aims and roles of physiotherapy in each of these clinical presentations and, in so doing, provides a synopsis of the pelvic health physiotherapy specialty in the UK.…”

Section: Pelvic Health Related Clinical Presentations; Including Role...mentioning

confidence: 99%

“…The use of bold text highlights where PoCUS imaging can complement or make those elements possible [5,8]; this includes where the modality may contribute to the physiotherapist's differential assessment, application of therapeutic intervention and patient education processes for a range of presentations.…”

Section: Pelvic Health Related Clinical Presentations; Including Role...mentioning

confidence: 99%

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Point of care ultrasound in pelvic health: scope of practice, education and governance for physiotherapists

Smith

Donnelly²,

Berry

et al. 2022

Int Urogynecol J

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Pelvic health and pelvic floor dysfunction have wide-reaching implications across a range of patient groups. Placing ultrasound imaging into the hands of assessing and treating clinicians (i.e. point of care ultrasound, PoCUS) can provide a step change in clinical effectiveness and efficiency. Pelvic floor dysfunction is managed by one or more members of a multi-disciplinary team that includes physiotherapists. Physiotherapists’ involvement includes diagnosis, patient education, identifying shared treatment goals, using rehabilitative strategies and empowering patients through self-management. Drawing upon existing publications in this area and applying framework principles, the authors propose a clinical and sonographic scope of practice for physiotherapists as part of supporting the consolidation and expansion of pelvic health PoCUS. Education and governance considerations are detailed to ensure the robust and safe use of this modality. Alongside empowering the use of ultrasound imaging by clinicians such as physiotherapists in the UK and internationally, we provide clarity to other members of the care pathway and ultrasound imaging professionals.

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“…Endoanal ultrasound (EAUS) and anal manometry are two modalities that can be used to aid counselling regarding mode of delivery in women with a history of OASI [3,4]. Three-dimensional EAUS is considered the gold standard investigation to evaluate the structure and integrity of the anal sphincter [3,5], whilst anal manometry and anorectal symptoms assess anal sphincter function [2]. Persistent anal sphincter defects are detected on EAUS in 34 [6] to 91% [7] of women with a history of OASI, despite primary repair.…”

Section: Introductionmentioning

confidence: 99%

Effect of a subsequent pregnancy on anal sphincter integrity and function after obstetric anal sphincter injury (OASI)

2020

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Introduction and hypothesis Endoanal ultrasound (EAUS) and anal manometry are used in the assessment women with a history of obstetric anal sphincter injury (OASI), both postpartum and in a subsequent pregnancy, to aid counselling regarding mode of delivery (MOD). Methods A prospective observational study between 2012 to 2020 was completed. Women were reviewed 3 months postpartum following OASI and in the second half of a subsequent pregnancy. Anorectal symptoms were measured using the validated St Mark’s Incontinence Score (SMIS: asymptomatic to mild symptoms = ≤ 4). Anal manometry (incremental maximum squeeze pressure [iMSP: normal = > 20 mmHg]) and EAUS (abnormal = sphincter defect > 1 h in size) were performed. Results One hundred forty-six women were identified and 67.8% had an anal sphincter defect ≤ 1 h in size postnatally. In those with a defect ≤ 1 h, postpartum mean iMSP and SMIS significantly improved in a subsequent pregnancy (p = 0.04 and p = 0.01, respectively). In women with a defect > 1 h, there was no significant difference between the mean iMSP or SMIS score postnatally compared to a subsequent pregnancy. At both time points, significantly more women had an anal sphincter defect ≤ 1 h and SMIS of ≤ 4 (p = 0.001 and p < 0.001 respectively) compared to those with a defect < 1 h. In addition, significantly more women had an anal sphincter defect ≤ 1 h and iMSP ≥ 20 mmHg (p < 0.001). Overall, out of the 146 women included in this study, 76 (52.1%) with a defect ≤ 1 h also had an iMSP ≥ 20 mmHg and SMIS ≤ 4 at 3 months postpartum. Conclusions Women who remain asymptomatic with normal anal manometry and no abnormal sphincter defects on EAUS postnatally do not need to have these investigations repeated in a subsequent pregnancy and can be recommended to have a vaginal delivery. If our protocol was modified, over half of the women in this study could have had their MOD recommendation made in the postnatal period alone.

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AIUM/IUGA Practice Parameter for the Performance of Urogynecological Ultrasound Examinations: Developed in Collaboration with the ACR, the AUGS, the AUA, and the SRU

Cited by 45 publications

References 54 publications

Urethral configuration and mobility during urine leaking described using real-time transperineal ultrasonography

Urethral configuration and mobility during urine leaking described using real-time transperineal ultrasonography

Point of care ultrasound in pelvic health: scope of practice, education and governance for physiotherapists

Effect of a subsequent pregnancy on anal sphincter integrity and function after obstetric anal sphincter injury (OASI)

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