The Role of Imaging in Assessing Perineal Trauma View Full Text


Ontology type: schema:Chapter     


Chapter Info

DATE

2016

AUTHORS

Xavier Fritel , Anne-Cécile Pizzoferrato , Vincent Letouzey , Guillaume Legendre , Renaud de Tayrac , Katharina Jundt , Arnaud Fauconnier

ABSTRACT

Pelvic floor disorders in women are highly prevalent affecting about a quarter of women with 10–20 % likely to have a surgical intervention for this pathology. A large proportion of pelvic floor disorders are related to perineal or pelvic floor trauma.The purpose of this chapter is to appraise modern imaging techniques for the pelvic floor, discussing their strengths and limitations, and to suggest management strategies designed to effectively utilise imaging use in everyday practice.Dynamic MRI provides an overall qualitative assessment of the pelvic floor and pelvic organ prolapse (POP). It achieves excellent differentiation of the type of prolapse in complex lesions. However, MRI staging is limited in everyday practice because it poorly correlates to the clinical examination. In order to avoid overtreatment a new MRI classification ensuring closer correlation with prolapse symptoms is clearly necessary. The main contribution of ultrasound consists in the study of pelvic-perineal meshes and urethral mobility assessment. Although endoanal ultrasound remains the gold standard for exploration of anal sphincter injuries, 3D perineal ultrasound can highlight atrophy or rupture of the anal sphincter while being much less invasive for patients.Currently available studies have a low level convincing evidence for the usefulness of imaging in surgical management of urinary incontinence or POP. Nevertheless, the most interesting potential field of application for future management may reside in accuracy of detection of levator ani muscle avulsion as a predictor of risk of prolapse and surgical repair failure. More... »

PAGES

115-145

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/978-3-319-14860-1_7

DOI

http://dx.doi.org/10.1007/978-3-319-14860-1_7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1084896463


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209 schema:name Service de Gynécologie-Obstétrique, CHU Carémeau, Nîmes, France
210 rdf:type schema:Organization
211 grid-institutes:grid.5252.0 schema:alternateName Department of Gynaecology and Obstetrics, University of Munich, Munich, Germany
212 schema:name Department of Gynaecology and Obstetrics, University of Munich, Munich, Germany
213 rdf:type schema:Organization
 




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