Practical Pelvic Floor Ultrasonography A Multicompartmental Approach to 2D 3D 4D Ultrasonography of the Pelvic Floor 2nd Edition by Abbas Shobeiri ISBN 9783319529295 3319529293

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ISBN 10: 3319529293
ISBN 13: 9783319529295
Author: Abbas Shobeiri

Practical Pelvic Floor Ultrasonography A Multicompartmental Approach to 2D 3D 4D Ultrasonography of the Pelvic Floor 2nd Edition Table of contents:

1: Pelvic Floor Anatomy

Introduction

Support of the Pelvic Organs: Conceptual Overview

Practical Anatomy and Prolapse

Overview

Apical Segment

Anterior Compartment

Perineal Membrane (Urogenital Diaphragm)

Posterior Compartment and Perineal Membrane

Lateral Compartment and the Levator Ani Muscles

Endopelvic Fascia and Levator Ani Interactions

The Levator Plate

Nerves

Summary

References

2: 2D/3D Endovaginal and Endoanal Instrumentation and Techniques

Introduction

2D Transperineal and 3D Endovaginal and Endoanal Ultrasound Imaging

The 2D Probes

The 3D Endocavitary High-Resolution Probes

BK 2052 Anorectal 3D Transducer (Endocavitary 360° Probe)

BK 8848 Endocavity Biplane Transducer

BK 8838 ART Transducer (Endocavitary 360° Probe)

BK 3D Viewer Software

Multicompartmental Ultrasonographic Techniques

Patient Positioning

2D Transperineal Functional Imaging

2D/3D Endovaginal Anterior Compartment Imaging

2D/3D Endovaginal Posterior Compartment Imaging

3D 360° Endovaginal Imaging

3D 360° Endoanal Imaging

Summary

References

3: Instrumentation and Techniques for Perineal and Introital Pelvic Floor Ultrasound

Introduction

Perineal Pelvic Floor Ultrasonography (pPFUS)

2D pPFUS

Pelvic Floor Muscle Contraction

Valsalva Maneuver

3D/4D pPFUS

GE 4D View Software

2D/3D/4D Introital Pelvic Floor Ultrasonography iPFUS

Basic Procedure and Equipment

Positioning

Probes

Equipment Preparation

iPFUS Orientation and Optimization

2D: Technique: Orientation

3D iPFUS: Technique

3D iPFUS: Pelvic Floor Hiatus—Orientation, Optimization, and Rotation

PFUS and Pelvic Floor Disorders

Pelvic Floor Biometry with PFUS

iPFUS and pPFUS: Pelvic Floor (Levator) Hiatus and Pelvic Floor Musculature

Levator Ani Avulsion

Anal Sphincter Complex and Anal Canal pPFUS and iPFUS

3D PFUS and MRI

iPFUS and pPFUS in the Evaluation and Treatment of Urinary Incontinence

iPFUS and pPFUS and Pelvic Organ Prolapse

Summary

References

4: Perineal Pelvic Floor Ultrasound: Applications and Literature Review

Introduction

Perineal Ultrasonography

2D Perineal Ultrasonography

3D/4D Perineal Ultrasonography Equipment

GE 4D View Software

2D/3D/4D Perineal Ultrasonography (pPFUS)

Basic Procedure and Equipment

pPFUS Role in Evaluation of Pelvic Floor Trauma During Childbirth

pPFUS Role in Evaluation of Urinary Incontinence

pPFUS Role in Evaluation of Pelvic Organ Prolapse

pPFUS Role in Evaluation of Fecal Incontinence

pPFUS Role in Evaluation of Vaginal Implants Such As Mesh and Bulking Agents

pPFUS Role in Planning Surgery and Summary/Future Directions

References

5: 3D Endovaginal Ultrasound Imaging of the Levator Ani Muscles

Introduction

Imaging Modalities for Endovaginal Imaging

3-D EVUS Technique for Levator Ani Imaging

Clinical Applications

Levator Ani Injury

LAD: Levator Ani Deficiency Score

Scoring System

Changes of Levator Ani with Aging

Levator Plate Descent Angle and Minimal Levator Hiatus

Conclusions and Future Research

References

6: 3D Endovaginal Ultrasound Imaging of Pelvic Floor Trauma

Introduction

Prevalence of Pelvic Floor Trauma Following Vaginal Delivery

3D Endovaginal Ultrasound Technique for Levator Ani Imaging in a Postpartum Patient

Reliability and Reproducibility Studies in Post-Partum Patients

Levator Ani Injury During Childbirth

Risk Factors

Repair

Levator Ani Deficiency Score as a Measure of Levator Ani Atrophy

Scoring System

Puboanalis/Puboperinealis Muscles

Puborectalis

Iliococcygeus/Pubococcygeus (Pubovisceralis)

Clinical Relevance of the Scoring System

Conclusions and Future Research

References

7: Endovaginal Urethra and Bladder Imaging

Introduction

Equipment, Technology, and Methodology

Patient Position

Patients Preparation

Methodology

BK 2050/2052/20R3 Anorectal 3D Transducer

BK 8848 Endocavity Biplane Transducer

Sagittal Section

Axial Section

BK 8838 3D ART Transducer

Vascular Render Mode and Maximum Intensity Projection

Urinary Bladder

Anatomy of Female Urethra and Bladder

Ultrasound Morphology

Urethral Vascularity

Clinical Applications of Urethral Ultrasound

Conclusions and Future Research

3D Endovaginal Ultrasound

3D EVUS in Interventional Treatment

Future Applications and Directions of Development

References

8: 2D/3D Transperineal and 3D Endovaginal Imaging of the Posterior Compartment

Introduction

Sonographic Anatomy

Transperineal Imaging

Endovaginal Imaging

Axial Plane

Sagittal Plane

Coronal Plane

Techniques and Literature Review

Transperineal Ultrasound

Clinical Applications

Rectocele

Enterocele

Rectal Intussusception

Endovaginal Ultrasound

Clinical Applications

Rectocele

Enterocele

Intussusception

Pelvic Floor Dyssynergy

Other Findings in the Posterior Pelvic Floor Compartment

Conclusions

References

9: Endovaginal Imaging: Vaginal Mesh and Implants

Introduction

History and Type of Vaginal Mesh

Ultrasonographic Findings of Mesh

Perineal/Introital Approach

Endovaginal Approach

Endoanal Approach

Mesh Complications and Ultrasonographic Findings

Mesh Contraction (Shrinkage)

Mesh Extrusion

Urinary Tract or Lower Gastrointestinal Tract Compromise or Perforation

Musculoskeletal: Pain, Lump, Decreased Elasticity, and Sinus Formation

Conclusion

References

10: Endovaginal Imaging: Slings

Introduction

Multicompartment Endovaginal Imaging in the Visualization of Slings

3D Imaging of Retropubic (Pubovaginal and Midurethral) and Transobturator Slings

Technical Details of Performing 3D EVUS to Visualize Slings

180° Scan of the Anterior Compartment

360° Scan

Manipulation of the 3D Data Volume to Trace the Intrapelvic Course of Slings, Retropubic, and

2D Dynamic Functional Assessment of the Slings

2D Dynamic Functional Assessment of Slings and Its Correlation with Outcome

Deformability of the Sling

Location of the Sling on Maximal Valsalva

Concordance of Urethral Movement with the Sling During Maximal Valsalva

2D Dynamic Assessment of Deformability of Different Sling Types

Diagnosis and Planning of Future Treatment in the Case of Failed Sling Surgery

Unknown Sling Type

Determining the Location of a Failed Sling

Planning of Treatment in Patients with Complicated Treatment History

Planning of Treatment in Patients with Voiding Dysfunction Following Sling Surgery

Slings and the Overactive Bladder

Comparison of Transperineal and Endovaginal Ultrasound in the Imaging of Slings

Anatomic Path of Transobturator Slings and Its Association with Pelvic Pain

Conclusions and Future Research

References

11: Imaging of Urethral Bulking Agents

Introduction

Potential of Multicompartmental Ultrasound Imaging in the Visualization of Periurethral Distrib

Technical Details of Performing 3D EVUS to Visualize Urethral Bulking Agents

Ultrasonographic Parameters of Bulking Agent Injection

Ideal Site of Injection

Periurethral Distribution of MPQ

Location of the Injection Plus Periurethral Distribution

Conclusion

References

12: Endovaginal Imaging: Pelvic Floor Cysts and Masses

Introduction

3D EVUS Technique

Bartholin Gland Cyst/Abscess

Skene Gland Cyst/Abscess

Urethral Diverticulum

Gartner Duct Cyst

Leiomyoma of Vagina

Malignant Vaginal Masses

Rectovaginal Septum Endometrioma

Vaginal Seroma and Hematoma

Conclusions and Key Points

References

13: Endoanal Ultrasonographic Imaging of the Anorectal Region

Introduction

Ultrasonographic Techniques

Endosonographic Anatomy of the Normal Anal Canal

Endosonographic Anatomy of the Rectum

Clinical Application of 3D Endoanal/Endorectal Ultrasound

Fecal Incontinence

Obstructed Defecation and Posterior Vaginal Wall Prolapse

Perianal Abscesses and Fistulas

References

14: Endoanal Imaging of Anorectal Cysts and Masses

Endometriosis

Deep Endometriosis

Perianal Endometriosis

Pre-sacral Neoplasia

Rare Tumors

Rectal Leiomyoma

Gastrointestinal Stromal Tumors (GIST)

Cystic Vaginal Lesion

Benign Urethral Lesion

Lymphocele

References

15: Ultrasound-Augmented Clinical Examination and Intraoperative Pelvic Floor Ultrasonography

Introduction

Clinical Pain Mapping in Mesh Patients

Intraoperative Ultrasound-Guided Botox of the Pelvic Floor

Intraoperative Ultrasound-Guided Sling Release

Intraoperative Ultrasound-Guided Repair of Levator Ani Tears

Intraoperative Assessment of Uterine and Vaginal Müllerian Anomalies

Intraoperative Assessment of Uterine Fibroids

Conclusions and Future Research

References

16: Ultrasound in Pelvic Floor Physiotherapy

Introduction

The Physical Therapist’s Role

The Role of Ultrasound in Physiotherapy

Older Women

Abdominal Ultrasound: 2D and 3D Abdominal Ultrasound of the Abdominal Muscles

Pelvic Floor Ultrasound Techniques

Ultrasound Tips and Techniques

Room for Scanning

Preparation and Hygiene

Orientation of the Ultrasound Picture on the Screen

Scan Technique

Special Tools of the Ultrasound Machines and Their Use

Physical Examination and Evaluation by a Pelvic Floor Therapist

Positioning During Examination: Influences on Therapy

Maneuvers During Evaluation

Palpation and Ultrasound

The Uses of Ultrasound to Assess Different Areas of Inquiry

The Use of Ultrasound to Quantify Levator Activity and to Teach a Pelvic Floor Muscle Contract

Assessment of Pelvic Floor Muscle Contraction in Urinary Incontinent Women

Assessment of Pelvic Floor Function in Fecally Incontinent Women and in Obstructed Defecation o

Assessment of Pelvic Floor Function in Pelvic Organ Prolapse

Assessment of Pelvic Floor Function in Patients with Pelvic Pain Syndrome

Integration of Ultrasound in Formulating a Treatment Plan

Summary and Future Directions for the Use of Ultrasound in Physiotherapy

References

17: Emerging Imaging Technologies and Techniques

Ultrasound Elasticity Imaging

Acoustic Radiation Force Impulse and Shear Wave Elasticity Imaging (ARFI and SWEI) of the Cervi

Photoacoustic Imaging of Ovarian Tissue and the Cervical Canal

Tactile Imaging of the Female Pelvic Floor

Functional Tactile Imaging

Summary

References

18: Patient-Specific Studies of Pelvic Floor Biomechanics Using Imaging

Introduction

Patient-Specific 3D Reconstruction of Female Pelvic Floor

Constitutive Material Properties of the Pelvic Floor

Future Outlook: Quantitative Assessment Using Ultrasound

Conclusion

References

19: Pelvic Floor Ultrasonography: Post-Test Questions

Post-Test Key

Index

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