Practical Pelvic Floor Ultrasonography – Shobeiri

This book gives the most up-to-date, state-of-the-art review of current literature, which provides an introduction to pelvic floor imaging that can be used during the initial evaluation and the subsequent urogynecology, colorectal surgery, and pelvic floor therapy visits. The reader will gain competence in performing transperineal 2D, 3D/4D, endovaginal, and endoanal 2D /3D ultrasound evaluation of the pelvic floor, including the anal sphincter and levator ani complex. The text provides a basic understanding of performing a transperineal, endovaginal, and endoanal pelvic floor ultrasound and using desktop 3D and 4D software to obtain basic measurements. High-quality diagrams and images complement concise textual information from acknowledged experts to provide a thorough update of this well-established field. Practical Pelvic Floor Ultrasonography, Third Edition, features new, fully updated, and expanded chapters. Introductory chapters fully elucidate the anatomical basis underlying disorders of the pelvic floor and the instrumentation and techniques required for endovaginal, endoanal, and 4D perineal and introital pelvic floor ultrasound. This is followed by a chapter reviewing the applications and literature for 4D perineal pelvic floor ultrasound. Next, the book covers 2D and 3D endovaginal imaging of the levator ani muscles, pelvic floor trauma, the urethra and bladder, and the anorectal area; 2D and 3D transperineal imaging; and 3D endoanal imaging. Case reviews are extensively expanded at the conclusion, and a final chapter challenges the reader to evaluate exemplar ultrasound images. Written entirely by experts in their fields, the third 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, obstetricians, gynecologists, female urologists, ultrasonographers, radiologists, physiotherapists, and fellows in urogynecology and colorectal surgery.

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Practical Pelvic Floor Ultrasonography

  1. Practical Pelvic Floor Ultrasonography
  2. Preface
  3. Contents
  4. Contributors
  5. 1. Pelvic Floor Anatomy
  6. Introduction
  7. Support of the Pelvic Organs: Conceptual Overview
  8. Practical Anatomy and Prolapse
  9. Overview
  10. Apical Segment
  11. Anterior Compartment
  12. Perineal Membrane (Urogenital Diaphragm)
  13. Posterior Compartment and Perineal Membrane
  14. Lateral Compartment and the Levator Ani Muscles
  15. Endopelvic Fascia and Levator Ani Interactions
  16. The Levator Plate
  17. Nerves
  18. Summary
  19. 2. 2D/3D Endovaginal and Endoanal Instrumentation and Techniques
  20. Introduction
  21. 2D Perineal and 2D/3D Endovaginal and Endoanal Ultrasound Imaging
  22. The 2D Probes
  23. The 3D Endocavitary High-Resolution Probes
  24. BK 3D Viewer Software
  25. Multicompartmental Ultrasonographic Techniques
  26. Patient Positioning
  27. 2D Perineal Functional Pelvic Floor Ultrasound (PFUS)
  28. 2D/3D Endovaginal Anterior Compartment Imaging
  29. 2D/3D Endovaginal Posterior Compartment Imaging
  30. 3D 360° Endovaginal Imaging (EVUS)
  31. 3D 360° Endoanal Imaging
  32. Summary
  33. 3. Instrumentation and Techniques for Perineal and Introital Pelvic Floor Ultrasound
  34. Introduction
  35. Perineal Pelvic Floor Ultrasonography (pPFUS)
  36. 2D pPFUS
  37. 3D/4D pPFUS
  38. GE 4D View Software
  39. 2D/3D/4D Introital Pelvic Floor Ultrasonography iPFUS
  40. iPFUS Orientation and Optimization
  41. PFUS and Pelvic Floor Disorders
  42. Pelvic Floor Biometry with PFUS
  43. iPFUS and pPFUS: Pelvic Floor (Levator) Hiatus and Pelvic Floor Musculature
  44. Anal Sphincter Complex and Anal Canal pPFUS and iPFUS
  45. iPFUS and pPFUS in the Evaluation and Treatment of Urinary Incontinence
  46. iPFUS and pPFUS and Pelvic Organ Prolapse
  47. Summary
  48. 4. Perineal Pelvic Floor Ultrasound: Applications and Literature Review
  49. Introduction
  50. Lower Urinary Tract Dysfunction and Anterior Compartment Pathologies
  51. Residual Urine and Detrusor Wall Thickness
  52. Stress Urinary Incontinence
  53. Pelvic Organ Prolapse
  54. Anterior Compartment
  55. Central Compartment
  56. Posterior Compartment
  57. The Anal Sphincter
  58. Synthetic Implants
  59. Mid-urethral Slings
  60. Mesh Implants for Pelvic Organ Prolapse
  61. Anterior Compartment Meshes
  62. Posterior Compartment Meshes
  63. The Levator Ani
  64. Summary
  65. 5. 3D Endovaginal Ultrasound Imaging of Levator Ani Muscles
  66. Introduction
  67. Imaging Modalities for Endovaginal Imaging
  68. 3D EVUS Technique for Levator Ani Imaging
  69. Clinical Applications
  70. Levator Ani Injury
  71. LAD: Levator Ani Deficiency Score
  72. Scoring System
  73. Changes of Levator Ani with Aging
  74. Levator Plate Descent Angle and Minimal Levator Hiatus
  75. Conclusions and Future Research
  76. 6. 3D Endovaginal Ultrasound Imaging of Levator Ani Trauma
  77. Introduction
  78. Prevalence of Pelvic Floor Trauma Following Vaginal Delivery
  79. Risk Factors
  80. Anatomy
  81. Supportive Structures of the Pelvic Floor that can be Injured
  82. Puboanalis/Puboperinealis Fibromuscularis
  83. Puborectalis
  84. Pubococcygeus
  85. Iliococcygeus
  86. 3D Endovaginal Ultrasound Technique for Levator Ani Imaging in Postpartum Patients
  87. Reliability and Reproducibility of Ultrasound Studies in Postpartum Patients
  88. Levator Ani Deficiency Score as a Measure of Levator Ani Injury and Atrophy
  89. 3D EVUS LAM Scoring System
  90. Clinical Relevance of the Scoring System
  91. Introduction to the Pathophysiology and Types of Skeletal Muscle Injuries
  92. Types of Levator Ani Injuries During Vaginal Birth
  93. Subgroup Analysis: Bilateral Injury Compared to Unilateral Injury
  94. Subgroup Analysis: Avulsion Compared to Pubococcygeus Injury
  95. Therapeutic Strategies
  96. RICE
  97. Physiotherapy
  98. NSAIDs
  99. Biological Repair
  100. Operative Treatment
  101. Reported Techniques for Levator Ani Muscle Repair
  102. Conclusions
  103. 7. Endovaginal Urethra and Bladder Imaging
  104. Introduction
  105. Equipment, Technology, and Methodology
  106. Patient Position
  107. Patients Preparation
  108. Methodology
  109. BK 2050/2052/20R3 Anorectal 3D Transducer
  110. BK 8848 Endocavity Biplane Transducer
  111. Sagittal Section
  112. Axial Section
  113. BK 8838 3D ART Transducer
  114. Vascular Render Mode and Maximum Intensity Projection
  115. Urinary Bladder
  116. Anatomy of Female Urethra and Bladder
  117. Ultrasound Morphology
  118. Urethral Vascularity
  119. Clinical Applications of Urethral Ultrasound
  120. Conclusions and Future Research
  121. 3D Endovaginal Ultrasound
  122. 3D EVUS in Interventional Treatment
  123. Future Applications and Directions of Development
  124. 8. 2D/3D Transperineal and 3D Endovaginal Imaging of the Posterior Compartment
  125. Introduction
  126. Techniques, Literature Review, and Sonographic Anatomy
  127. Transperineal Ultrasound 2D/3D Static and Dynamic Imaging
  128. Rectocele
  129. Enterocele
  130. Rectal Intussusception
  131. Endovaginal 2D/3D Static Imaging
  132. Axial Plane
  133. Sagittal Plane
  134. Coronal Plane
  135. Endovaginal 2D Dynamic Imaging
  136. Biomechanics of Evacuation
  137. Dynamic Posterior Compartment Ultrasound Measurements of Rectal Hypermobility/Folding
  138. Clinical Applications of Static 3D Endovaginal Ultrasound
  139. Rectocele
  140. Enterocele
  141. Intussusception
  142. Pelvic Floor Dyssynergy
  143. Simplified Diagnostic Algorithm to Assess Obstructed Defecation Symptoms
  144. Other Findings in the Posterior Pelvic Floor Compartment
  145. Conclusions
  146. 9. Endovaginal Imaging: Vaginal Mesh and Implants
  147. Introduction
  148. Pelvic Floor Anatomy as it Relates to the Design and Development of Vaginal Mesh Kits
  149. Anterior Compartment
  150. Posterior Compartment and Perineal Membrane
  151. History and Type of Vaginal Mesh
  152. Ultrasonographic Findings of Mesh
  153. Mesh Complications and Ultrasonographic Findings
  154. Mesh Contraction
  155. Mesh Exposure and Extrusion
  156. Urinary Tract or Lower Gastrointestinal Tract Compromise or Perforation
  157. Musculoskeletal Structure: Pain, Lump, Decreased Elasticity, and Sinus Tract Formation
  158. Summary
  159. 10. Endovaginal Imaging: Slings
  160. Introduction
  161. Multicompartment Endovaginal Imaging in the Visualization of Slings
  162. 3D Imaging of Retropubic (Pubovaginal and Midurethral) and Transobturator Slings
  163. Technical Details of Performing 3D EVUS to Visualize Slings
  164. 180° Scan of the Anterior Compartment
  165. 360° Scan
  166. Manipulation of the 3D Data Volume to Trace the Intrapelvic Course of Slings, Retropubic, and Transobturator
  167. 2D Dynamic Functional Assessment of the Slings
  168. 2D Dynamic Functional Assessment of Slings and Its Correlation with Outcome
  169. Deformability of the Sling
  170. Location of the Sling on Maximal Valsalva
  171. Concordance of Urethral Movement with the Sling During Maximal Valsalva
  172. 2D Dynamic Assessment of Deformability of Different Sling Types
  173. Diagnosis and Planning of Future Treatment in the Case of Failed Sling Surgery
  174. Unknown Sling Type and Preoperative Scanning in Case of a Failed Sling
  175. Determining the Location of a Failed Sling
  176. Planning of Treatment in Patients with Complicated Treatment History
  177. Diagnosis of Tape Erosion/Extrusion
  178. Planning of Treatment in Patients with Voiding Dysfunction Following Sling Surgery
  179. Slings and the Overactive Bladder
  180. Comparison of Transperineal and Endovaginal Ultrasound in the Imaging of Slings
  181. Anatomic Path of Transobturator Slings and Its Association with Pelvic Pain
  182. Conclusions and Future Research
  183. 11. 2D/3D Ultrasound Imaging of Urethral Bulking Materials
  184. Introduction
  185. Potential of Multicompartmental Ultrasound in Visualizing Periurethral Distribution of Bulking Agents: Why Bother?
  186. Technical Details of Performing 3D EVUS to Visualize Urethral Bulking Agents
  187. Ultrasonographic Parameters of Bulking Agent Injection
  188. Ideal Site of Injection
  189. Periurethral Distribution of MPQ
  190. Location of the Bulkamid Periurethral Bulking Material
  191. Location of the Injection Plus Periurethral Distribution
  192. Conclusion
  193. 12. Endovaginal Imaging: Pelvic Floor Cysts and Masses
  194. Introduction
  195. 3D EVUS Technique
  196. Bartholin Gland Cyst/Abscess
  197. 3D EVUS Appearance of Bartholin Gland Cyst
  198. Skene Gland Cyst/Abscess
  199. 3D EVUS Appearance of Skene Gland Cyst
  200. Urethral Diverticulum
  201. 3D EVUS Appearance of Urethral Diverticulum
  202. Gartner Duct Cyst
  203. 3D EVUS Appearance of Gartner Duct Cyst
  204. Leiomyoma of Vagina
  205. 3D EVUS Appearance of Leiomyoma
  206. Malignant Vaginal Masses
  207. 3D EVUS Appearance of Malignant Vaginal Masses
  208. Rectovaginal Septum Endometrioma
  209. 3D EVUS Appearance of Rectovaginal Septum Endometrioma
  210. Vaginal Seroma and Hematoma
  211. 3D EVUS Appearance of Vaginal Seroma and Hematoma
  212. Conclusions and Key Points
  213. 13. Endoanal Ultrasonographic Imaging of the Anorectal Region
  214. Introduction
  215. Ultrasonographic Techniques
  216. Endosonographic Anatomy of the Normal Anal Canal
  217. Endosonographic Anatomy of the Rectum
  218. Clinical Application of 3D Endoanal/Endorectal Ultrasound
  219. Fecal Incontinence
  220. Obstructed Defecation and Posterior Vaginal Wall Prolapse
  221. Perianal Abscesses and Fistulas
  222. 14. Endoanal Imaging of Anorectal Cysts and Masses
  223. Endometriosis
  224. Deep Endometriosis
  225. Perianal Endometriosis
  226. Presacral Neoplasia
  227. Rare Tumors
  228. Rectal Leiomyoma
  229. Gastrointestinal Stromal Tumors (GIST)
  230. Rectovaginal Septum Tumors
  231. Cystic Vaginal Lesion
  232. Prostatic Cyst Lesion
  233. Benign Urethral Lesion
  234. Lymphocele
  235. 15. Role of Ultrasound in the Evaluation and Management of Obstetric Anal Sphincter Injuries
  236. Introduction
  237. Diagnosis of Obstetric Anal Sphincter Injuries
  238. Endoanal Ultrasound
  239. Transperineal Ultrasound
  240. OASI Follow-Up
  241. Pelvic Floor Symptoms Evaluation
  242. Physical Examination
  243. Anal Testing
  244. Physical Therapy Interventions After OASI
  245. Mode of Delivery in Future Pregnancies
  246. Conclusions
  247. 16. Strategies to Reduce Severe Perineal Lacerations
  248. Introduction
  249. Overview of the Sections
  250. Sections
  251. Risk Factors for Perineal Trauma During Childbirth
  252. Episiotomy
  253. Operative Vaginal Delivery
  254. Persistent Occiput Posterior Position
  255. Fetal Birth Weight
  256. Induction and Augmentation
  257. Length of Second Stage
  258. Regional Anesthesia
  259. Maternal Familial Factors
  260. The Safe Passages Program
  261. Perineal Massage
  262. Induction of Labor
  263. Warm Compresses (Fig. 16.1)
  264. Coaching of Maternal Pushing
  265. Delivery Position (Fig. 16.2)
  266. Perineal Support (Figs. 16.3, 16.4, and 16.5)
  267. Use of Episiotomy
  268. Shoulder Dystocia Strategies
  269. Operative Vaginal Deliveries
  270. Repair of Perineal Lacerations (Figs. 16.6 and 16.7)
  271. Outcomes of the Simulation Training
  272. Summary
  273. 17. Ultrasound-Augmented Clinical Examination and Intraoperative Pelvic Floor Ultrasonography
  274. Introduction
  275. Clinical Pain Mapping in Mesh Patients
  276. Intraoperative Ultrasound-Guided Botox of the Pelvic Floor
  277. Intraoperative Ultrasound-Guided Sling Release
  278. Intraoperative Ultrasound-Guided Repair of Levator Ani Tears
  279. Intraoperative Assessment of Uterine and Vaginal Mullerian Anomalies
  280. Intraoperative Assessment of Uterine Fibroids
  281. Conclusions and Future Research
  282. 18. Ultrasound Imaging in Pelvic Health Physical Therapy
  283. Introduction
  284. Physical Therapist Utilization of Rehabilitative Ultrasound Imaging
  285. Scope of Practice in Pelvic Health
  286. Clinical Diagnosis Versus Functional Assessment
  287. Pressure System Management
  288. Instrumentation and Approaches for the Pelvic Health Physiotherapist
  289. Instrumentation
  290. 2D Ultrasound in Physiotherapy
  291. Equipment Preparation
  292. Patient Preparation
  293. Scanning Planes and Approaches
  294. Scanning Modes
  295. Clinical Applications of Ultrasound Imaging in Pelvic Floor Physiotherapy
  296. Imaging Techniques for Assessment and Training of the Pelvic Floor
  297. 2D Transabdominal Versus 2D Perineal Pelvic Floor Ultrasound Imaging
  298. Patient Positioning
  299. Transabdominal Ultrasound Approach
  300. Scan Technique
  301. TAUS Anatomy: Tissue Morphology and Morphometry
  302. TAUS Observing Motor Control Strategies: Voluntary and Involuntary
  303. TAUS Training Motor Control Strategies: Voluntary and Involuntary
  304. Perineal Pelvic Floor Ultrasound (pPFUS) Approach
  305. Scan Technique
  306. pPFUS Anatomy: Tissue Morphology and Morphometry
  307. pPFUS Observing Pelvic Floor Behaviors: Voluntary and Involuntary
  308. pPFUS: Training Motor Control Strategies—Voluntary and Involuntary
  309. US Research Within the Field of Physiotherapy
  310. Summary
  311. 19. Emerging Imaging Technologies and Techniques
  312. Ultrasound Shear Wave Elasticity Imaging
  313. Acoustic Radiation Force Impulse and Shear Wave Elasticity Imaging (ARFI and SWEI) of the Cervix and Uterus
  314. Photoacoustic Imaging of Ovarian Tissue and the Cervical Canal
  315. Tactile Imaging of the Female Pelvic Floor
  316. Summary
  317. 20. Patient-Specific Studies of Pelvic Floor Biomechanics Using Imaging
  318. Introduction
  319. Patient-Specific 3D Reconstruction of the Female Pelvic Floor
  320. Constitutive Material Properties of the Pelvic Floor
  321. Future Outlook
  322. Automated Segmentation of Pelvic Floor Structures
  323. Quantitative Ultrasound Imaging
  324. Conclusion
  325. 21. Case Studies
  326. Index
Edición

3

ISBN

9783031924859

Año Edición

2025

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