S M Murad-Regadas1,2,3, S A Karbage4,5,6, L S Bezerra4,5,6, F S P Regadas7, A da Silva Vilarinho5, L B Borges5, F S P Regadas Filho5, L B Veras7. 1. Unit of Pelvic Floor and Anorectal Physiology, Department of Surgery, School of Medicine, Clinical Hospital, Federal University of Ceará, Av Pontes Vieira, 2551, Fortaleza, CE, 60130-241, Brazil. smregadas@hospitalsaocarlos.com.br. 2. Unit of Pelvic Floor and Anorectal Physiology, Clinical Hospital, Federal University of Ceará, Fortaleza, CE, Brazil. smregadas@hospitalsaocarlos.com.br. 3. Unit of Pelvic Floor and Anorectal Physiology, Department of Colorectal Surgery, Sao Carlos Hospital, Fortaleza, CE, Brazil. smregadas@hospitalsaocarlos.com.br. 4. Unit of Pelvic Floor and Anorectal Physiology, Clinical Hospital, Federal University of Ceará, Fortaleza, CE, Brazil. 5. Unit of Pelvic Floor and Anorectal Physiology, Department of Colorectal Surgery, Sao Carlos Hospital, Fortaleza, CE, Brazil. 6. Department of Gynecology, School of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil. 7. Unit of Pelvic Floor and Anorectal Physiology, Department of Surgery, School of Medicine, Clinical Hospital, Federal University of Ceará, Av Pontes Vieira, 2551, Fortaleza, CE, 60130-241, Brazil.
Abstract
BACKGROUND: The aim of this study was to evaluate the role of dynamic translabial ultrasound (TLUS) in the assessment of pelvic floor dysfunction and compare the results with echodefecography (EDF) combined with the endovaginal approach. METHODS: Consecutive female patients with pelvic floor dysfunction were eligible. Each patient was assessed with EDF combined with the endovaginal approach and TLUS. The diagnostic accuracy of the TLUS was evaluated using the results of EDF as the standard for comparison. RESULTS: A total of 42 women were included. Four sphincter defects were identified with both techniques, and EDF clearly showed if the defect was partial or total and additionally identified the pubovisceral muscle defect. There was substantial concordance regarding normal relaxation and anismus. Perfect concordance was found with rectocele and cystocele. The rectocele depth was measured with TLUS and quantified according to the EDF classification. Fair concordance was found for intussusception. There was no correlation between the displacement of the puborectal muscle at maximum straining on EDF with the displacement of the anorectal junction (ARJ), compared at rest with maximal straining on TLUS to determine perineal descent (PD). The mean ARJ displacement was similar in patients with normal and those with excessive PD on TLUS. CONCLUSIONS: Both modalities can be used as a method to assess pelvic floor dysfunction. The EDF using 3D anorectal and endovaginal approaches showed advantages in identification of the anal sphincters and pubodefects (partial or total). There was good correlation between the two techniques, and a TLUS rectocele classification based on size that corresponds to the established classification using EDF was established.
BACKGROUND: The aim of this study was to evaluate the role of dynamic translabial ultrasound (TLUS) in the assessment of pelvic floor dysfunction and compare the results with echodefecography (EDF) combined with the endovaginal approach. METHODS: Consecutive female patients with pelvic floor dysfunction were eligible. Each patient was assessed with EDF combined with the endovaginal approach and TLUS. The diagnostic accuracy of the TLUS was evaluated using the results of EDF as the standard for comparison. RESULTS: A total of 42 women were included. Four sphincter defects were identified with both techniques, and EDF clearly showed if the defect was partial or total and additionally identified the pubovisceral muscle defect. There was substantial concordance regarding normal relaxation and anismus. Perfect concordance was found with rectocele and cystocele. The rectocele depth was measured with TLUS and quantified according to the EDF classification. Fair concordance was found for intussusception. There was no correlation between the displacement of the puborectal muscle at maximum straining on EDF with the displacement of the anorectal junction (ARJ), compared at rest with maximal straining on TLUS to determine perineal descent (PD). The mean ARJ displacement was similar in patients with normal and those with excessive PD on TLUS. CONCLUSIONS: Both modalities can be used as a method to assess pelvic floor dysfunction. The EDF using 3D anorectal and endovaginal approaches showed advantages in identification of the anal sphincters and pubodefects (partial or total). There was good correlation between the two techniques, and a TLUS rectocele classification based on size that corresponds to the established classification using EDF was established.
Authors: H S Kaufman; J L Buller; J R Thompson; H K Pannu; S L DeMeester; R R Genadry; D A Bluemke; B Jones; J L Rychcik; G W Cundiff Journal: Dis Colon Rectum Date: 2001-11 Impact factor: 4.585
Authors: F Sergio P Regadas; Eric M Haas; Maher A Abbas; J Marcio Jorge; Angelita Habr-Gama; Dana Sands; Steven D Wexner; Ingrid Melo-Amaral; Carlos Sardiñas; Doryane M Lima; Univaldo E Sagae; Evaldo U Sagae; Sthela M Murad-Regadas Journal: Dis Colon Rectum Date: 2011-06 Impact factor: 4.585
Authors: Sthela M Murad-Regadas; F Sérgio P Regadas; Lusmar V Rodrigues; Flavio R Silva; Fabio A Soares; Rodrigo D Escalante Journal: Surg Endosc Date: 2007-08-20 Impact factor: 4.584
Authors: R F Grasso; S Piciucchi; C C Quattrocchi; M Sammarra; V Ripetti; B Beomonte Zobel Journal: Ultrasound Obstet Gynecol Date: 2007-07 Impact factor: 7.299