Anal Sphincter Complex: 2D and 3D Endoanal and Translabial Ultrasound Measurement Variation in Normal Postpartum Measurements

Overview

Journal Int Urogynecol J

Publisher Springer

Specialties Gynecology & Obstetrics
Urology

Date 2014 Oct 26

PMID 25344221

Citations 4

Authors

Kate V Meriwether

Rebecca J Hall

Lawrence M Leeman

Laura Migliaccio

Clifford Qualls

Rebecca G Rogers

Affiliations

Soon will be listed here.

Abstract

Introduction And Hypothesis: Women may experience anal sphincter anatomy changes after vaginal birth (VB) or Cesarean delivery (CD). Therefore, accurate and acceptable imaging options to evaluate the anal sphincter complex (ASC) are needed. ASC measurements may differ between translabial (TLUS) and endoanal (EAUS) ultrasound imaging and between 2D and 3D US. The objective of this analysis was to describe measurement variation between these modalities.

Methods: Primiparous women underwent 2D and 3D TLUS imaging of the ASC 6 months after VB or CD. A subset of women also underwent EAUS measurements. Measurements included internal anal sphincter (IAS) thickness at proximal, mid, and distal levels and the external anal sphincter (EAS) at 3, 6, 9, and 12 o'clock positions, as well as bilateral thickness of the pubovisceralis muscle (PVM).

Results: There were 433 women presenting for US: 423 had TLUS and 64 had both TLUS and EAUS of the ASC. All IAS measurements were significantly thicker on TLUS than EAUS (all p < 0.01), while EAS measurements were significantly thicker on EAUS (p < 0.01). PVM measurements with 3D or 2D imaging were similar (p > 0.20). On both TLUS and EAUS, there were multiple sites where significant asymmetry existed in left versus right measurements.

Conclusions: US modality used to image the ASC introduces small but significant changes in measurements, and the direction of the bias depends on the muscle and location being imaged.

Citing Articles

The effect of vaginal delivery and Caesarean section on the anal Sphincter complex of Primipara based on optimized three-dimensional ultrasound image and nuclear regression Reconstruction Algorithm.

He N, Shi L Pak J Med Sci. 2021; 37(6):1641-1646.

PMID: 34712298 PMC: 8520362. DOI: 10.12669/pjms.37.6-WIT.4859.

Perianal ultrasound (PAUS): visualization of sphincter muscles and comparison with digital-rectal examination (DRE) in females.

Holscher M, Graf C, Stickelmann A, Stickeler E, Najjari L BMC Womens Health. 2021; 21(1):247.

PMID: 34144688 PMC: 8214294. DOI: 10.1186/s12905-021-01387-1.

Pelvic floor symptoms and quality of life changes during first pregnancy: a prospective cohort study.

Rogers R, Ninivaggio C, Gallagher K, Borders A, Qualls C, Leeman L Int Urogynecol J. 2017; 28(11):1701-1707.

PMID: 28417155 PMC: 5673482. DOI: 10.1007/s00192-017-3330-7.

The relationship of 3-D translabial ultrasound anal sphincter complex measurements to postpartum anal and fecal incontinence.

Meriwether K, Hall R, Leeman L, Migliaccio L, Qualls C, Rogers R Int Urogynecol J. 2015; 26(8):1191-9.

PMID: 26085463 PMC: 4578155. DOI: 10.1007/s00192-015-2676-y.

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