Interrater reliability of assessing levator ani deficiency with 360° 3D endovaginal ultrasound

Rostaminia, Ghazaleh; Manonai, Jittima; LeClaire, Edgar L.; Omoumi, Farid H.; Marchiorlatti, M.; Quiroz, Lieschen H.; Shobeiri, S. Abbas

doi:10.1007/s00192-013-2286-5

Cited by 44 publications

(47 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The results showed that the rhabdomyosphincter contracted synergistically with the levator ani muscle during all maneuvers except abdominal contraction [25]. Several studies have established the reliability of ultrasonography in the evaluation of both the levator ani muscles [11,12] and urethral sphincter complex [16,15,29] as independent structures. However, the morphologic relationship between the two has not been investigated using ultrasonography.…”

Section: Discussionmentioning

confidence: 99%

“…Based on published studies [3,11,12], the levator ani muscle was divided into three subgroups: the puboperinealis/puboanalis (PA), the puborectalis (PR), and the iliococcygeus/pubococcygeus (PV). The PA subgroup, which is poorly studied, is the perineal stabilizer, while the PR is the squeezer, and the PV is the elevator.…”

Section: Levator Ani Muscle Scoring Systemmentioning

confidence: 99%

“…Anatomically, muscle loss is replaced by fatty infiltration of the muscles and on ultrasonography, this increased water content is visualized as decreased or absent echogenicity. The following validated scoring system was used [12]: 0 no muscle defect, 1 minimal defect with 50 % or less muscle loss, 2 major defect with more than 50 % muscle loss, and 3 total absence of muscle (Fig. 1).…”

Section: Levator Ani Muscle Scoring Systemmentioning

confidence: 99%

“…The levator ani muscle is arranged in a unique threedimensional structure that makes it accessible by ultrasonography [11,12] and magnetic resonance imaging (MRI) [13,14]. In the same way, the urethral sphincter musculature can also be easily visualized and readily measured using endovaginal ultrasonography (EVUS) [15,16], intraurethral ultrasonography [17,18] and MRI [19][20][21].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Is there a correlation between levator ani and urethral sphincter complex status on 3D ultrasonography?

et al. 2014

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Levator Ani Muscle Scoring Systemmentioning

confidence: 99%

Section: Levator Ani Muscle Scoring Systemmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Is there a correlation between levator ani and urethral sphincter complex status on 3D ultrasonography?

et al. 2014

Self Cite

View full text Add to dashboard Cite

show abstract

“…By using the same 360°rotational mechanical probe as used for EAUS, this procedure provides 3D high-resolution images of the anatomical structures of the pelvic floor [13]. It allows assessment of female urethral complex [14], biometric indices of the levator hiatus [15], damage of the levator ani [16], endopelvic fascia and/or the perineal body [17].…”

mentioning

confidence: 99%

Imaging the pelvic floor

Santoro

2017

Tech Coloproctol

View full text Add to dashboard Cite

Urinary and fecal incontinence, obstructed defecation, pelvic pain and pelvic organ prolapse are common in older multiparous women, affecting approximately 16% of females aged 40-56 years [1]. As we evaluate a patient with a clinically evident anatomic defect (rectocele, rectal prolapse, perineal descent), it is essential to establish whether this defect is really associated with the patient's symptoms (obstructed defecation). Moreover, a pelvic floor disorder in one compartment frequently coexists with disorders involving other compartments. Indeed, rather than considering the pelvic floor as divided into three vertical compartments, the current concept is to approach the pelvic floor as a horizontal structure [1]. The pelvic floor is a three-dimensional mechanical apparatus that acts as a unit, with a close interrelationship between organ systems, fascia and ligaments, muscles, vessels and nerves. Because the levator ani muscle provides support to all three organ systems, its weakness will result in impaired function of any, or all, of the structures that the muscle supports. In addition, damage to the endopelvic, pubocervical or rectovaginal fascias will lead to herniation of one organ system into another. This is demonstrated by the common coexistence of prolapse of the anterior and posterior vaginal walls requiring repair of both. Understanding pelvic floor anatomy is therefore crucial for an effective management of these dysfunctions.A careful preoperative evaluation is key to determining the pathophysiology of pelvic floor dysfunction [2]. Clinical examination, however, is not accurate in diagnosing anatomical defects of the posterior vaginal wall, overestimating the presence of rectocele (large false-positive rate) but missing enterocele or intussusception in patients with primary pelvic organ prolapse (large false-negative rate) [3,4]. Imaging allows the clinician to better evaluate the patients in order to determine what anatomical alterations are present, and this leads to appropriate surgical interventions and increased success rates [5]. Traditional evacuation proctography or colpocystoproctography, modern dynamic magnetic resonance imaging and ultrasound can be used for visualization of the pelvic floor [5]. Advantages of ultrasound over the other imaging modalities are that it is more widely available, more cost-effective, less time-consuming, and associated with better patient compliance. It is performed by the clinician during office consultation and can be considered as an extension of the physical examination. The development of new technological innovations such as three-/four-dimensional (3D/4D) tools, video-recording, post-processing analysis and the standardization of methodology and terminology [6] have made ultrasound imaging more reproducible and less operator dependent.Several ultrasound techniques can be used to assess the pelvic floor [6]. Translabial ultrasound (TLUS) is performed with the patient placed in the dorsal lithotomy position, with hips flexed and abducted, by using a con...

show abstract

Accuracy of MRI, ultrasound and vaginal assessment for the diagnosis of levator ani muscle avulsion in women

Gruting

Delft

Thakar

et al. 2015

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Interrater reliability of assessing levator ani deficiency with 360° 3D endovaginal ultrasound

Abstract: Our study demonstrates excellent agreement between raters assessing levator ani muscle deficiency using 3D endovaginal ultrasound. This level of concordance supports the reliability of the 3D endovaginal ultrasound technique and scoring method among raters [corrected].

Cited by 44 publications

References 25 publications

Is there a correlation between levator ani and urethral sphincter complex status on 3D ultrasonography?

Is there a correlation between levator ani and urethral sphincter complex status on 3D ultrasonography?

Imaging the pelvic floor

Accuracy of MRI, ultrasound and vaginal assessment for the diagnosis of levator ani muscle avulsion in women

Contact Info

Product

Resources

About