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International Urogynecology Journal

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01-12-2009 | Original Article

Assessment of pelvic floor muscle contraction in stress urinary incontinent women: comparison between transabdominal ultrasound and perineometry

Authors: Mahshid Chehrehrazi, Amir Massoud Arab, Noureddin Karimi, Mahtab Zargham

Published in: International Urogynecology Journal | Issue 12/2009

Abstract

Introduction and hypothesis

Transabdominal (TA) ultrasound and perineometry have been currently used to assess lifting aspect and squeezing action of pelvic floor muscles (PFM) function, respectively, in women with stress urinary incontinence (SUI). However, no study has directly compared these measurements. The purpose of this study was to investigate the reliability and correlation between perineometry and TA ultrasound as measurements of different aspect of PFM function.

Methods

A total of 28 women with SUI participated in the study. Vaginal squeeze pressure using a perineometer and bladder base movement on TA ultrasound was measured. Scattergram was depicted to determine the correlation between variables. Intraclass correlation coefficient and Bland–Altman plot were used to assess reliability.

Results

Scatter diagram depicted significant correlation of TA ultrasound with vaginal squeeze pressure (r = 0.72, R ² = 0.52, p < 0.0001). High reliability was found for measurements.

Conclusion

TA ultrasound measurement may be an alternative measurement to perineometry when assessing PFM function.

Bø K, Sherburn M (2005) Evaluation of female pelvic-floor muscle function and strength. Phys Ther 85:269–282PubMed

Sapsford R, Hodges P (2001) Contraction of the pelvic floor muscles during abdominal manoeuvers. Arch Phys Med Rehabil 82:1081–1088CrossRefPubMed

Amro J, Gameiro M, Padovani C (2003) Treatment of urinary stress incontinence by intravaginal electrical stimulation and pelvic floor physiotherapy. Int Urogynecol J Pelvic Floor Dysfunct 14:204–208CrossRef

Bø K (2003) Pelvic floor muscle strength and response to pelvic muscle training for stress urinary incontinence. Neurourol Urodyn 22:654–658CrossRefPubMed

Dumoulin C, Hay-Smith J (2008) Pelvic floor muscle training versus no treatment for urinary incontinence in women. A Cochrane systematic review. Eur J Phys Rehabil Med 44:47–63PubMed

Isherwood PJ, Rane A (2000) Comparative assessment of pelvic floor strength using a perineometer and digital examination. BJOG 107:1007–1011CrossRefPubMed

Bø K, Finckenhagen HB (2001) Vaginal palpation of pelvic floor muscle strength: inter-test reproducibility and comparison between palpation and vaginal squeeze pressure. Acta Obstet Gynecol Scand 80:883–887PubMed

Morin M, Dumoulin C, Bourbonnais D, Gravel D, Lemieux M (2004) Pelvic floor maximal strength using vaginal digital assessment compared to dynamometric measurements. Neurourol Urodyn 23:336–341CrossRefPubMed

Hundley AF, Wu JM, Visco AG (2005) A comparison of perineometer to brink score for assessment of pelvic floor muscle strength. Am J Obstet Gynecol 192:1583–1591CrossRefPubMed

10.

Kegel A (1948) Progressive resistance exercise in the functional restoration of the perineal muscles. Am J Obstet Gynecol 56:238–249PubMed

11.

Frawley H, Galea M, Phillips B, Sherburn M, Bø K (2006) Effect of test position on pelvic floor muscle assessment. Int Urogynecol J Pelvic Floor Dysfunct 17:365–371CrossRefPubMed

12.

Uyar Y, Baytur YB, Inceboz U (2007) Perineometer and digital examination for assessment of pelvic floor strength. Int J Gynaecol Obstet 98:64–65CrossRefPubMed

13.

Thompson JA, O’Sullivan PB, Briffa NK, Neumann P, Court S (2005) Assessment of pelvic floor movement using transabdominal and transperineal ultrasound. Int Urogynecol J Pelvic Floor Dysfunct 16:285–292CrossRefPubMed

14.

Thompson JA, O’Sullivan PB, Briffa NK, Neumann P (2007) Comparison of transperineal and transabdominal ultrasound in the assessment of voluntary pelvic floor muscle contractions and functional manoeuvres in continent and incontinent women. Int Urogynecol J Pelvic Floor Dysfunct 18:779–786CrossRefPubMed

15.

Sherburn M, Murphy CA, Carroll S, Allen TJ, Galea MP (2005) Investigation of transabdominal real-time ultrasound to visualize the muscles of the pelvic floor. Aust J Physiother 51:167–170PubMed

16.

Kelly M, Tan BK, Thompson J, Carroll S, Follington M, Arndt A et al (2007) Healthy adults can more easily elevate the pelvic floor in standing than in crook-lying: an experimental study. Aust J Physiother 53:187–191PubMed

17.

Bø K, Sherburn M, Allen T (2003) Transabdominal ultrasound measurement of pelvic floor muscle activity when activated directly or via a transversus abdominis muscle contraction. Neurourol Urodyn 22:582–588CrossRefPubMed

18.

Thompson J, O’Sullivan P, Briffa NK, Court S (2003) A comparison between transabdominal and transperineal ultrasound in the assessment of women performing pelvic floor exercises. Aust N Z Continence 9:92–93

19.

Dietz HP, Jarvis SK, Vancaillie TG (2002) The assessment of levator muscle strength: a validation of three ultrasound techniques. Int Urogynecol J Pelvic Floor Dysfunct 13:156–159CrossRefPubMed

20.

Thompson JA, O’Sullivan PB, Briffa NK, Neumann P (2006) Assessment of voluntary pelvic floor muscle contraction in continent and incontinent women using transperineal ultrasound, manual muscle testing and vaginal squeeze pressure measurements. Int Urogynecol J Pelvic Floor Dysfunct 17:624–630CrossRefPubMed

21.

Abrams p, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U (2003) The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the international continence society. Urology 61:37–49CrossRefPubMed

22.

Ishiko O, Hirai K, Sumi T, Nishimura S, Ogita S (2000) The urinary incontinence score in the diagnosis of female urinary incontinence. Int J Gynaecol Obstet 68:131–137CrossRefPubMed

23.

Bø K, Kvarstein B, Hagen R, Larsen S (1990) Pelvic floor muscle exercise for the treatment of female stress urinary incontinence: II. Validity of vaginal pressure measurements of pelvic floor muscle strength and the necessity of supplementary methods for control of correct contraction. Neurourol Urodyn 9:479–487CrossRef

24.

Bump R, Mattiasson A, Bi K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17CrossRefPubMed

25.

Bower FW, Chase JW, Stillman BC (2006) Normative pelvic floor parameters in children assessed by transabdominal ultrasound. J Urol 176:337–341CrossRefPubMed

26.

Peschers UM, Gingelmaier A, Jundt K, Leib B, Dimpfl T (2001) Evaluation of pelvic floor muscle strength using four different techniques. Int Urogynecol J Pelvic Floor Dysfunct 12:27–30CrossRefPubMed

Title: Assessment of pelvic floor muscle contraction in stress urinary incontinent women: comparison between transabdominal ultrasound and perineometry
Authors: Mahshid Chehrehrazi
Amir Massoud Arab
Noureddin Karimi
Mahtab Zargham
Publication date: 01-12-2009
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 12/2009
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-009-0977-8

At a glance: The STEP trials

Springer Medicine

Assessment of pelvic floor muscle contraction in stress urinary incontinent women: comparison between transabdominal ultrasound and perineometry

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

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