The Journal of Minimally Invasive Gynecology
Volume 17, Issue 3 , Pages 282-294 , May 2010

The Role of Two- and Three-Dimensional Dynamic Ultrasonography in Pelvic Organ Prolapse

  • Hans Peter Dietz, MD, PhD

      Affiliations

    • Corresponding Author InformationCorresponding author: Hans Peter Dietz, MD, PhD, Department of Obstetrics and Gynaecology, Sydney Medical School Nepean, Nepean Hospital, Penrith, NSW 2750, Australia.

Received 23 September 2009 ,Accepted 24 December 2009.

References 

  1. Bump RC, Mattiasson A, Bo K, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;175:10–17
  2. O'Boyle AL, Woodman PJ, O'Boyle JD, Davis GD, Swift SE. Pelvic organ support in nulliparous pregnant and nonpregnant women: a case control study. [erratum appears in Am J Obstet Gynecol. 2003;188:301] Am J Obstet Gynecol. 2002;187:99–102
  3. Dietz H, Eldridge A, Grace M, Clarke B. Pelvic organ descent in young nulliparous women. Am J Obstet Gynecol. 2004;191:95–99
  4. Dalpiaz O, Curti P. Role of perineal ultrasound in the evaluation of urinary stress incontinence and pelvic organ prolapse: a systematic review. Neurourol Urodyn. 2006;25:301–306
  5. Dietz H, Lanzarone V. Levator trauma after vaginal delivery. Obstet Gynecol. 2005;106:707–712
  6. Kearney R, Miller J, Ashton-Miller J, Delancey J. Obstetric factors associated with levator ani muscle injury after vaginal birth. Obstet Gynecol. 2006;107:144–149
  7. Dietz HP, Steensma AB. The prevalence of major abnormalities of the levator ani in urogynaecological patients. Br J Obstet Gynaecol. 2006;113:225–230
  8. Shek K, Dietz H. The effect of childbirth on hiatal dimensions: a prospective observational study. Obstet Gynecol. 2009;113:1272–1278
  9. Krofta L, Otcenasek M, Kasikova E, Feyereisl J. Pubococcygeus-puborec talis trauma after forceps delivery: evaluation of the levator ani muscle with 3D/4D ultrasound. Int Urogynecol J. 2009;20:1175–1181
  10. Lien KC, Mooney B, DeLancey JO, Ashton-Miller JA. Levator ani muscle stretch induced by simulated vaginal birth. Obstet Gynecol. 2004;103:31–40
  11. Svabik K, Shek K, Dietz H. How much does the levator hiatus have to stretch during childbirth?. Br J Obstet Gynaecol. 2009;116:1657–1662
  12. Lanzarone V, Dietz H. 3Dimensional ultrasound imaging of the levator hiatus in late pregnancy and associations with delivery outcomes. Aust NZ J Obstet Gynaecol. 2007;47:176–180
  13. Balmforth J, Toosz- Hobson P, Cardozo L. Ask not what childbirth can do to your pelvic floor but what your pelvic floor can do in childbirth. Neurourol Urodyn. 2003;22:540–542
  14. Dietz H, Gillespie A, Phadke P. Avulsion of the pubovisceral muscle associated with large vaginal tear after normal vaginal delivery at term. Aust NZ J Obstet Gynaecol. 2007;47:341–344
  15. Wallner C, Wallace C, Maas C, et al. A high resolution 3D study of the female pelvis reveals important anatomical and pathological details of the pelvic floor. Neurourol Urodyn. 2009;28:668–670
  16. Sarma S, Hersch M, Siva S, Dietz H, Moore K. Pelvic floor damage and childbirth: a neurophysiological study. Neurourol Urodyn. 2009;28(S1):680–681
  17. Swash M, Snooks SJ, Henry MM. Unifying concept of pelvic floor disorders and incontinence. J R Soc Med. 1985;78:906–911
  18. Allen RE, Hosker GL, Smith AR, Warrell DW. Pelvic floor damage and childbirth: a neurophysiological study. Br J Obstet Gynaecol. 1990;97:770–779
  19. Dietz HP, Haylen BT, Vancaillie TG. Female pelvic organ prolapse and voiding function. Int Urogynecol J. 2002;13:284–288
  20. Eisenberg V, Shek KL, Dietz HP. Avulsion defect and cystocele: is there a link?. Ultrasound Obstet Gynecol. 2009;34(S1):8
  21. Tsai M, Tsai K, Liu C, Ho E, Long C. Perineal ultrasonography in diagnosing anterior vaginal leiomyoma resembling a cystocele. Ultrasound Obstet Gynecol. 2007;30:1013–1014
  22. Dietz HP, Korda A. Which bowel symptoms are most strongly associated with a true rectocele?. Aust NZ J Obstet Gynaecol. 2005;45:505–508
  23. Dietz HP, Steensma AB. Posterior compartment prolapse on two-dimensional and three-dimensional pelvic floor ultrasound: the distinction between true rectocele, perineal hypermobility and enterocele. Ultrasound Obstet Gynecol. 2005;26:73–77
  24. Perniola G, Shek K, Dietz H, Chong C, Cartmill J, Chew S. Can ultrasound replace xray proctography in women with obstructed defecation?. Ultrasound Obstet Gynecol. 2008;31:567–571
  25. Steensma AB, Oom DMJ, Burger CW, Schouten WR. Comparison of defecography and 3D/ 4D translabial ultrasoundin patients with pelvic organ prolapse and/ or evacuation disorders. Ultrasound Obstet Gynecol. 2007;30:447
  26. Konstantinovic ML, Steensma AB, Domali E, et al. Correlation between 3D/4D translabial ultrasound and colpocystodefecography in diagnosis of posterior compartment prolapse. Ultrasound Obstet Gynecol. 2007;30:448
  27. Grasso R, Piciucchi S, Quattrocchi C, Sammarra M, Ripetti V, Beomonte Zobel B. Posterior pelvic floor disorders: a prospective comparison using introital ultrasound and colpocystodefecography. Ultrasound Obstet Gynecol. 2007;30:86–94
  28. Oerno A, Dietz H. Levator co-activation is a significant confounder of pelvic organ descent on Valsalva maneuver. Ultrasound Obstet Gynecol. 2007;30:346–350
  29. Richardson AC. The rectovaginal septum revisited: its relationship to rectocele and its importance in rectocele repair. Clin Obstet Gynecol. 1993;36:976–983
  30. Dietz HP, Shek KL. Validity and reproducibility of the digital detection of levator trauma. Int Urogynecol J. 2008;19:1097–1101
  31. Dietz HP, Shek C. Levator avulsion and grading of pelvic floor muscle strength. Int Urogynecol J. 2008;19:633–636
  32. Kearney R, Miller JM, Delancey JO. Interrater reliability and physical examination of the pubovisceral portion of the levator ani muscle, validity comparisons using MR imaging. Neurourol Urodynam. 2006;25:50–54
  33. Debus-Thiede G. Magnetic resonance imaging (MRI) of the pelvic floor. In:  Schuessler B,  Laycock J,  Norton P,  Stanton SL editor. Pelvic floor reeducation- principles and practice. London: Springer; 1994;p. 78–82
  34. Toosz-Hobson P, Athanasiou S, Khullar V, Boos K, Anders K, Cardozo LD. Does vaginal delivery damage the pelvic floor?. Neurourol Urodynam. 1997;16:385–386
  35. Athanasiou S, Chaliha C, Toozs-Hobson P, Salvatore S, Khullar V, Cardozo L. Direct imaging of the pelvic floor muscles using two-dimensional ultrasound: a comparison of women with urogenital prolapse versus controls. Br J Obstet Gynaecol. 2007;114:882–888
  36. Dietz H. Ultrasound imaging of the pelvic floor: 3D aspects. Ultrasound Obstet Gynecol. 2004;23:615–625
  37. Dietz H. Quantification of major morphological abnormalities of the levator ani. Ultrasound Obstet Gynecol. 2007;29:329–334
  38. Dietz H, Shek K. Tomographic ultrasound of the pelvic floor: which levels matter most?. Neurourol Urodyn. 2008;27(S1):639–640
  39. Dietz H, Shek K. Can 2D translabial ultrasound be used to diagnose levator avulsion?. Int Urogynecol J. 2008;19(S1):S163–S164
  40. DeLancey J, Morgan D, Fenner D, et al. Comparison of levator ani muscle defects and function in women with and without pelvic organ prolapse. Obstet Gynecol. 2007;109:295–302
  41. Dietz H. Levator trauma in labour: a challenge for obstetricians, surgeons and sonologists. Ultrasound Obstet Gynecol. 2007;29:368–371
  42. Abdool Z, Shek K, Dietz H. The effect of levator avulsion on hiatal dimensions and function. Am J Obstet Gynecol. 2009;201:89;e1-5
  43. Krofta L, Kasikova E, Otcenasek M, Feyereisl J. Pubococcygeus- puborectalis trauma after instrumental delivery: the use of 4D ultrasound in the evaluation of levator ani muscle. Ultrasound Obstet Gynecol. 2007;30:446
  44. Dietz H, Simpson J. Does delayed childbearing increase the risk of levator injury in labour?. Austr NZ J Obstet Gynaecol. 2007;47:491–495
  45. Shek KL, Chantarasorn V, Dietz HP. Can levator avulsion be predicted antenatally?. Am J Obstet Gynecol. 2010 Jan 13;
  46. Abdool Z, Shek K, Dietz H. The effect of levator avulsion on hiatal dimensions and function. Am J Obstet Gynecol. 2009;201:89.e81–89.e85
  47. Otcenasek M, Krofta L, Baca V, et al. Bilateral avulsion of the puborectal muscle: magnetic resonance imaging-based three-dimensional reconstruction and comparison with a model of a healthy nulliparous woman. Ultrasound Obstet Gynecol. 2007;29:692–696
  48. Brooks S, Zerba E, Faulkner J. Injury to muscle fibres after single stretches of passive and maximally stimulated muscle in mice. J Physiol. 1995;488:459–469
  49. Dietz H, De Leon J, Shek K. Ballooning of the levator hiatus. Ultrasound Obstet Gynecol. 2008;31:676–680
  50. Dietz H, Simpson J. Levator trauma is associated with pelvic organ prolapse. Br J Obstet Gynaecol. 2008;115:979–984
  51. DeLancey JO. Anatomy. In:  Cardozo L,  Staskin D editor. Textbook of female urology and urogynaecology. London: Isis Medical Media; 2001;p. 112–124
  52. Dietz H, Shek K, Clarke B. Biometry of the pubovisceral muscle and levator hiatus by three-dimensional pelvic floor ultrasound. Ultrasound Obstet Gynecol. 2005;25:580–585
  53. Dietz H, Kirby A, Shek K, Bedwell P. Does avulsion of the puborectalis muscle affect bladder function?. Int Urogynecol J. 2009;
  54. Wilson PD, Hay Smith EJ, Nygaard IE, et al. Adult conservative management. In:  Abrams P,  Cardozo L,  Khoury S,  Wein A editor. Incontinence: Third International Consultation on Incontinence. Vol. 2:Paris: Health Publications Ltd; 2005;p. 855–964
  55. Chantarasorn V, Shek KL, Dietz HP. Levator avulsion is not associated with fecal incontinence. Int Urogynecol J. 2009;20(S2):S169–S170
  56. Adekanmi OA, Freeman R, Puckett M, Jackson S. Cystocele: Does anterior repair fail because we fail to correct the fascial defects? A clinical and radiological study. Int Urogynecol J. 2005;16(S2):S73
  57. Dietz HP, Chantarasorn V, Shek KL. Avulsion of the puborectalis muscle is a risk factor for recurrence after anterior repair. Int Urogynecol J. 2009;20(S2):S172–S173
  58. Model A, Shek KL, Dietz HP. Do levator defects increase the risk of prolapse recurrence after pelvic floor surgery?. Neurourol Urodyn. 2009;28(S1):888–889
  59. Shobeiri S, Chimpiri A, Allen AC, Nihira M, Quiroz LH. Surgical reconstitution of a unilaterally avulsed symptomatic puborectalis muscle using autologous fascia lata. Obstet Gynecol. 2009;114(S2):480–482

 Dr. Dietz has acted as a consultant for AMS and CCS, has received speaker's honoraria from GE and Astellas, and has received equipment loans from GE, Toshiba and B-K Medical.

PII: S1553-4650(09)01351-X

doi: 10.1016/j.jmig.2009.12.022

The Journal of Minimally Invasive Gynecology
Volume 17, Issue 3 , Pages 282-294 , May 2010