Pelvic Floor Ultrasound

Ultrasound has replaced X-ray as the main imaging modality for the diagnosis of pelvic floor disorders in women. It now enables a cost-effective and non-invasive demonstration of bladder neck and pelvic organ mobility, vaginal, urethral and levator ani function and anatomy, and anorectal anatomy. Atlas of Pelvic Floor Ultrasound provides an introduction to pelvic floor imaging as well as a resource to be used during initial and more advanced practice.

There is increasing interest in using ultrasound for assessment of pelvic floor disorders such as voiding dysfunction , pelvic organ prolapse and faecal incontinence. Ultrasound can also be a useful imaging modality for urodynamics and pelvic floor physiotherapy. Whilst ultrasound equipment is widely available around the world many clinicians may not have access to structured training in the technique of pelvic floor imaging and interpretation of images in the context of pelvic floor dysfunction. This book aims to provide the reader with the knowledge and skills to start utilising ultrasound imaging in assessment of pelvic floor disorders. The authors comprise the three surgical disciplines (urology, colorectal surgery and gynaecology) who commonly manage pelvic floor problems and have subspecialty expertise in pelvic floor imaging. They have conducted workshops in Australia, Asia, UK and USA and are advocates for clinican-performed ultrasound.

This new edition provides the most up to date, state-of-the art review of current literature which provides an introduction to pelvic floor imaging, as well as a resource to be used during initial and more advanced practice. The book features new chapters on Vaginal mesh imaging, ultrasound of implanted material, pelvic floor trauma, and ultrasound in pelvic floor therapy. The reader will gain competence in performing transperineal, endovaginal and endoanal 3D/4D ultrasound evaluation of the pelvic floor including anal sphincter and levator ani complex. The text provides a basic understanding of how to perform a transperineal, an endovaginal and endoanal pelvic floor ultrasound and use the desktop 3D/4D softwares to obtain basic measurements. Concise textual information from acknowledged experts is complemented by high-quality diagrams and images to provide a thorough update of this rapidly evolving field. Introductory chapters fully elucidate the anatomical basis underlying disorders of the pelvic floor, followed by 1) 3D/4D transperineal imaging, 2) 3D endovaginal imaging of the urethra and the bladder, Levator ani muscles, the anorectal area, and 3) 3D endoanal imaging. Measurement protocols and case reviews are demonstrated at the conclusion. Written entirely by experts in their fields, the second edition of Practical Pelvic Floor Ultrasonography: A Multicompartmental Approach to 2D/3D/4D Ultrasonography of the Pelvic Floor is a comprehensive resource that will be of great value to urogynecologists, colorectal surgeons, obstetrician and gynecologists, female urologists, ultrasonographers, radiologists, physiotherapists, as well as fellows in urogynecology and colorectal surgery. /div

This book represents a landmark in the development of an imaging subspecialty that crosses the clinical boundaries of urogynaecology and coloproctology. It is the first text to consider the imaging of all pelvic floor disorders, addressing in depth both urinary and faecal incontinence and the various forms of prolapse. The book begins with a magnetic resonance-based review of the anatomy of the pelvic floor and an overview of how it functions; detailed chapters on investigation and treatment then follow, from both a clinical and a radiological perspective.

All the characteristics and driving force of The Cleveland Clinic are to be found in this book on pelvic ?oor function. The Cleveland Clinic is a group practice founded in 1921 on the principles of cooperation,collaboration,and collegiality.Its founders believed that many physicians working together will discover better solutions to medical problems than physicians working in isolation. They believed that the combination of disciplines, with their inherent differences in philosophy and skills, will produce a better outcome than might have evolved singularly. The power of the collaborative approach is on full display in this book. The pelvic ?oor unites three separate organ systems. Before this time, each has been approached individually. Urologists, gynecologists, and colorectal surgeons are each trained in their own disciplines, and the pelvic ?oor is subsumed in these larger ?elds of study. When they combine their focus on the pelvic ?oor, they bring their unique perspectives and different approaches to a common goal: the relief of pelvic ?oor syndromes such as incontinence and pelvic organ prolapse.

Ultrasonography is a cornerstone in the evaluation of gynecologic disease. This authoritative new book looks at the techniques of ultrasonography in both office and hospital settings, offering guidance on the optimal use of equipment and covering the full range of benign and malignant gynecologic disease as well as infertility. Ultrasonography in Gynecology offers extensive coverage of the diagnostic potential of ultrasound in gynecologic disease, from the moment the patient walks into the physician's office. All the different approaches in the ultrasonographic evaluation of disease – including 3D ultrasonography, 3D sonohysterography, Doppler imaging and pelvic floor imaging – are extensively covered, with color images throughout. Written and edited by leaders in the field of ultrasonography who have actively participated in national and international teaching courses, Ultrasonography in Gynecology is a must for all gynecologists dealing with infertility, endometriosis, uterine fibroids, gynecologic cancers, and many more gynecologic conditions.

Recent evolution brought ultrasound imaging widely adopted by pelvic floor specialists. For gynecologists, this step has been a natural evolution. In fact, pelvic floor medicine is the last field of gynecology in which ultrasound has reached a pivotal role in the diagnostic process. But when we consider the pelvic floor as a transversal field of medicine we must consider that ultrasound is the linking bridge between different specialties. In fact, ultrasound is a cohesive tool shared by gynecologists, urologists, colorectal surgeons, and radiologists. Most of them are confident with this technique and are familiar with the technology even though with different applications. Most of the time ultrasound can be performed by the same specialist that collected the medical history and has performed the physical evaluation. This aspect allows ultrasound to express the best of itself since the clinician perfectly knows what he/she requires to obtain by the imaging. In this sense, ultrasound fills a gap in the steps of the diagnostic workup, melting physical examination, and imaging all in one, making them much more than complementary. In the same manner, ideally, the same clinician who fulfilled the diagnostic path may be the main character involved in the surgical process which aims to solve the specific pelvic floor dysfunction. Nevertheless, pelvic floor ultrasound partially departs from the applications clinicians are used to for their specialty. As gynecologists in fact we recognize differences between ultrasound pelvic studies for uterine or adnexal masses and pelvic floor studies. The same is for other specialties. For this reason, clinicians involved in pelvic floor units need education in pelvic floor ultrasound in order to be skilled for specific applications. With this vision we tried our best to offer pelvic floor specialists a handbook with the basic ultrasound knowledge they need to own in order to complete a pelvic floor diagnostic step in current clinical practice, providing a rich iconography of normal and pathological imaging. The cut of the work is intentionally concise but complete with practical tips for a correct ultrasound evaluation of the pelvic floor. The handbook is suitable both as a first approach to pelvic floor ultrasound and also for expert practitioners who wish to improve their skills.

Dramatic improvement in imaging techniques (3D ultrasonography, dynamic magnetic resonance) allows greater insight into the complex anatomy of the pelvic floor and its pathological modifications.Obstetrical events leading to fecal and urinary incontinence in women, the development of pelvic organ prolapse, and mechanism of voiding dysfunction and obstructed defecation can now be accurately assessed, which is fundamental for appropriate treatment decision making. This book is written for gynecologists, colorectal surgeons, urologists, radiologists, and gastroenterologists with a special interest in this field of medicine. It is also relevant to everyone who aspires to improve their understanding of the fundamental principles of pelvic floor disorders.