Pelvic Floor Imaging

Pelvic floor disorders including urinary incontinence, pelvic organ prolapse, and anal incontinence have high prevalence in women of all ages,(1) can significantly decrease quality of life, and produce an economic effect. Proper evaluation of pelvic floor muscle function, strength, and integrity is an important component of diagnosis and treatment of pelvic floor disorders. In addition, the pelvic floor muscle training used to change the structural support and strength of muscle contraction requires clinicians to be able to conduct high-quality measurements of pelvic floor muscle function and strength. Studies have shown that up to one-third of women do not know how to contract their pelvic floor muscles correctly.(2) Therefore, it is also important to be able to assess pelvic muscle function and strength to document a patient's progress during interventions designed to improve their strength.(3) Approximately 1 in 10 women undergo surgery for pelvic organ prolapse by the time they reach the age of 70 years.(4) In addition, urinary incontinence often coexists with pelvic organ prolapse.(1) Urinary incontinence is defined by the International Continence Society as a complaint of any involuntary leakage of urine.(5) The most common type of incontinence is involuntary leaking in response to increased intra-abdominal pressures during exertion, cough, or sneeze. This type of incontinence is called stress urinary incontinence.(6) Urinary incontinence is more common in women than it is in men, and it affects women of all ages. The prevalence ranges from 9% to 72%, with an incidence that rises steeply with age.(7) Several studies have documented the effects that urinary incontinence have on quality of life; it is a debilitating disorder that affects women socially and physically.(6) The International Consultation on Incontinence defines anal incontinence as the involuntary loss of gas, liquid, or stool that causes a social or hygienic problem.(8) The prevalence of anal incontinence has been documented in several studies to range from 20% to 54%.(9,10) The underlying cause of this type of incontinence is often related to anal sphincter defects following vaginal deliveries.(11) Because these disorders are so prevalent and severely affect a woman's quality of life, it is important to understand normal pelvic anatomy and function to treat pelvic floor disorders appropriately.(12)