Current capabilities of ultrasound diagnosis of pelvic floor dysfunction

Pelvic floor dysfunction is a complex of abnormal functioning of the pelvic floor muscles and ligamentous apparatus, which leads to disruption of work and descent/prolapse of the pelvic organs. Damages to the support structures of the pelvic floor can contribute to pelvic floor dysfunction. The prevalence of genital prolapse increases with age. According to demographic indicators, there is an increase in women’s life expectancy, including the duration of the menopause period in the female population, which is associated with a decrease in estrogen levels and a worse connective tissue quality, which contributes to the formation of pelvic floor dysfunction. Consequently, genital prolapse is becoming more common. The suggestions have been made that the incidence of genital prolapse will double in the next 30 years. Currently, the problem of genital prolapse is called a hidden epidemic. Among the available diagnostic methods, such as X-rays, computed tomography, magnetic resonance imaging (MRI), and echography, the latter absolutely has an advantage for imaging the pelvic floor. This technique is safe, simple, cheap, readily available, and provides high spatial and temporal resolution. The paper presents the possibilities of modern ultrasound multiparametric visualization of pelvic floor structures. In connection with the improvement of three-dimensional ultrasound technologies, volumetric ultrasound has become a new tool to diagnose the status of the pelvic floor. 3D imaging allows determining the axial plane with good spatial and temporal resolution. Multislice computed tomography, like MRI, promotes layer-by-layer assessment of all structures and differentiation of microtraumas of the pelvic floor muscles. Conclusion: Ultrasound imaging has become an important tool not only for the timely diagnosis of pelvic floor dysfunction, but also for the prevention of genital prolapse.

pelvic floor, pelvic organ prolapse, urinary incontinence, MRI of the pelvic organs, pelvic floor ultrasound, 3D ultrasound, multislice