Three-dimensional transperineal ultrasonography for evaluation of the anal sphincter complex: another dimension in understanding peripartum sphincter trauma

Three‐dimensional transperineal sonographic characteristics of the anal sphincter complex in nulliparous women

“…However, several authors have commented on the drawbacks of this imaging method, including its poor ability to assess the external anal sphincter, distortion of the anal canal by the transducer and patient discomfort. For these reasons, they have recommended transvaginal or transperineal ultrasound, which are easily performed with the patient resting supine2, 12–14.…”

Transperineal three‐dimensional ultrasound in evaluating anal sphincter muscles

“…The anal canal has been imaged using two‐dimensional (2D) endoanal ultrasound1–4, magnetic resonance imaging (MRI)3, 5–11 and, more recently, using three‐dimensional (3D) endoanal ultrasound6, 12, 13. Investigators are now beginning to explore the use of 3D ultrasound with transperineal and transvaginal approaches to study this region12, 14–17. Early work regarding the clinical use of 3D ultrasound in obstetrics, gynecology, interventional radiology, urology and gastroenterology is encouraging13–16, 18–24.…”

Transperineal Sonographic Anal Sphincter Complex Evaluation in Chronic Anal Fissures

“…Diagnosis of these occult tears is of primary importance: first, because earlier diagnosis and repair have been shown to be important in preventing fecal incontinence; and second, for effective counseling aimed at the prevention of anal sphincter damage during subsequent deliveries 12 . Salvans et al 23 stated that the presence of sphincter defects was not related to sex ( P = .172), although it did correlate with younger ages ( P = .028).…”

“…Three‐dimensional (3D) endoanal sonography improves diagnostic confidence in detecting damage to the anal sphincter complex 11 . Three‐dimensional transperineal sonography provides the advantage of volume storage capability to shorten the examination time with the patient present, allows for later consultation if necessary, and makes the examination relatively operator independent 12 . Using 3D transperineal sonography, Valsky and Yagel 13 found that 7.9% of patients had occult damage to the anal sphincter (Figures 1 and 2).…”