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Published in: International Urogynecology Journal 3/2011

01-03-2011 | Original Article

Pubococcygeal activity on perineal ultrasound in incontinent women

Authors: Mara de Abreu Etienne, André Lima de Oliveira, Silvia da Silva Carramão, José Rafael Macea, Tsutomu Aoki, Antonio Pedro Flores Auge

Published in: International Urogynecology Journal | Issue 3/2011

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Abstract

Introduction and hypothesis

The aim of this study was to investigate the applicability and reproducibility of perineal ultrasound (US) in the evaluation of the pubococcygeal muscle (PCM) activity in urinary incontinent women.

Methods

Thirty women were assessed twice by two examiners who measured the angle between the lateral bundles of the PCM. The 2D US on coronal view evaluated the PCM performance during squeezing, straining, and resting.

Results

There was significant correlation (p ≤ 0.001) in all measurements to both examiners, except for the contraction on their second assessment. The images showed asymmetries of muscle volume and activity. Five women (16.7%) had difficulty to rest after squeezing or straining, six (20%) first opened the muscle bundles when asked to squeeze them, and eight (26.7%) had no movement during different moments.

Conclusions

The 2D perineal US on coronal view is useful to evaluate PCM activity. It is easily applicable and reproducible.
Literature
1.
go back to reference Messelink B, Benson T, Berghmans B, Bo K, Corcos J, Fowler C et al (2005) The standardization of terminology of pelvic floor muscle function and dysfunction: report from the pelvic floor clinical assessment group of the International Continence Society. Neurourol Urodyn 24:374–380CrossRefPubMed Messelink B, Benson T, Berghmans B, Bo K, Corcos J, Fowler C et al (2005) The standardization of terminology of pelvic floor muscle function and dysfunction: report from the pelvic floor clinical assessment group of the International Continence Society. Neurourol Urodyn 24:374–380CrossRefPubMed
2.
go back to reference Petros PE, Ulmsten U (1997) Role of the pelvic floor in bladder neck opening and closure II: vagina. Int Urogynecol J 8:69–73CrossRef Petros PE, Ulmsten U (1997) Role of the pelvic floor in bladder neck opening and closure II: vagina. Int Urogynecol J 8:69–73CrossRef
3.
go back to reference DeLancey JOL, Kearney R, Chou Q, Speights S, Binno S (2003) The appearance of levator ani muscle abnormalities in magnetic resonance images after vaginal delivery. Obstet Gynecol 101:46–53CrossRefPubMed DeLancey JOL, Kearney R, Chou Q, Speights S, Binno S (2003) The appearance of levator ani muscle abnormalities in magnetic resonance images after vaginal delivery. Obstet Gynecol 101:46–53CrossRefPubMed
4.
go back to reference Dietz HP, Jarvis SK, Vancaillie TG (2002) The assessment of levator muscle strength: a validation of three ultrasound techniques. Int Urogynecol J 13:156–159CrossRef Dietz HP, Jarvis SK, Vancaillie TG (2002) The assessment of levator muscle strength: a validation of three ultrasound techniques. Int Urogynecol J 13:156–159CrossRef
5.
go back to reference Bernstein IT (1997) The pelvic floor muscles: muscle thickness in health and urinary incontinent women measured by perineal ultrasonography with reference to the effect of pelvic floor training. Estrogen receptor studies. Neurourol Urodyn 16:237–275CrossRefPubMed Bernstein IT (1997) The pelvic floor muscles: muscle thickness in health and urinary incontinent women measured by perineal ultrasonography with reference to the effect of pelvic floor training. Estrogen receptor studies. Neurourol Urodyn 16:237–275CrossRefPubMed
6.
go back to reference Petros PE (2007) The female pelvic floor, 2nd edn. Springer, Berlin Petros PE (2007) The female pelvic floor, 2nd edn. Springer, Berlin
7.
go back to reference Dietz HP, Shek KL (2009) Levator defects can be detected by 2D translabial ultrasound. Int Urogynecol J 20:807–811CrossRef Dietz HP, Shek KL (2009) Levator defects can be detected by 2D translabial ultrasound. Int Urogynecol J 20:807–811CrossRef
8.
go back to reference Dietz HP, Hyland G, Hay-Smith J (2006) The assessment of levator trauma: a comparison between palpation and 4D pelvic floor ultrasound. Neurourol Urodyn 25:424CrossRefPubMed Dietz HP, Hyland G, Hay-Smith J (2006) The assessment of levator trauma: a comparison between palpation and 4D pelvic floor ultrasound. Neurourol Urodyn 25:424CrossRefPubMed
9.
go back to reference Bo K, Sherburn M (2005) Evaluation of female pelvic floor muscle function and strength. Phys Ther 85:269–282PubMed Bo K, Sherburn M (2005) Evaluation of female pelvic floor muscle function and strength. Phys Ther 85:269–282PubMed
10.
go back to reference Peschers UM, Gingelmaier A, Jundt K, Leib B, Dimpfl T (2001) Evaluation of pelvic floor muscle strength using four different techniques. Int Urogynecol J 12:27–30CrossRef Peschers UM, Gingelmaier A, Jundt K, Leib B, Dimpfl T (2001) Evaluation of pelvic floor muscle strength using four different techniques. Int Urogynecol J 12:27–30CrossRef
11.
go back to reference Dietz HP, Wilson PD, Clarke B (2001) The use of perineal ultrasound to quantify levator activity and teach pelvic floor muscle exercises. Int Urogynecol J 12:166–169CrossRef Dietz HP, Wilson PD, Clarke B (2001) The use of perineal ultrasound to quantify levator activity and teach pelvic floor muscle exercises. Int Urogynecol J 12:166–169CrossRef
12.
go back to reference Braekken IH, Majida M, Ellstrom-Engh M, Dietz HP, Umek W, Bo K (2008) Test-retest and intra-observer repeatability of two-, three- and four-dimensional perineal ultrasound of pelvic floor muscle anatomy and function. Int Urogynecol J 19:227–235CrossRef Braekken IH, Majida M, Ellstrom-Engh M, Dietz HP, Umek W, Bo K (2008) Test-retest and intra-observer repeatability of two-, three- and four-dimensional perineal ultrasound of pelvic floor muscle anatomy and function. Int Urogynecol J 19:227–235CrossRef
13.
go back to reference Bump R, Mattiasson A, Bo K, Brubaker LD, DeLancey JOL, Klarskov P et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17CrossRefPubMed Bump R, Mattiasson A, Bo K, Brubaker LD, DeLancey JOL, Klarskov P et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17CrossRefPubMed
14.
go back to reference Laycock J, Jerwood D (2001) Pelvic floor muscle assessment: the perfect scheme. Physiotherapy 12:631–642CrossRef Laycock J, Jerwood D (2001) Pelvic floor muscle assessment: the perfect scheme. Physiotherapy 12:631–642CrossRef
15.
go back to reference Thompson JA, O’Sullivan PB (2003) Levator plate movement during pelvic floor muscle contraction in subjects with incontinence and prolapsed: a cross-sectional study and review. Int Urogynecol J 14:84–88CrossRef Thompson JA, O’Sullivan PB (2003) Levator plate movement during pelvic floor muscle contraction in subjects with incontinence and prolapsed: a cross-sectional study and review. Int Urogynecol J 14:84–88CrossRef
16.
go back to reference Thompson JA, O’Sullivan P, Briffa K, 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 17:624–630CrossRef Thompson JA, O’Sullivan P, Briffa K, 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 17:624–630CrossRef
Metadata
Title
Pubococcygeal activity on perineal ultrasound in incontinent women
Authors
Mara de Abreu Etienne
André Lima de Oliveira
Silvia da Silva Carramão
José Rafael Macea
Tsutomu Aoki
Antonio Pedro Flores Auge
Publication date
01-03-2011
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 3/2011
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-010-1251-9

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