Updated Recommendations on Ultrasonography in Urogynecology

This article presents a practical, standardized approach to evaluating pelvic floor conditions, using affordable equipment and transducers for the clinical practitioner.

“Ultrasound is a supplementary diagnostic procedure in urogynecology, which allow documentation of functional and morphologic findings. The patient’s history, clinical examination, urodynamic testing, and imaging continue to be the cornerstones of comprehensive urogynecologic work-up.”

Recommendations distinguish between two techniques based on the type of probe: 1) endocavity ultrasound, specifically endoanal ultrasound (EAUS), using a 2D, 360o probe (10-12.5MHz); and 2) external ultrasound, for transperineal ultrasound (TPUS), using a general purpose probe (3.5-5MHz), or introital ultrasound (IUS), using an end-fire vaginal probe (5-7.5 MHz). The introital approach is noted as particularly convenient as it uses the same probe as for endovaginal ultrasound (EVUS) applications.

This article details recommended standards for the urogynecologist, including image orientation, measurement methods, and examination position. It includes clinical applications for both endocavity and external ultrasound, and describes functional testing and the role of ultrasound in perioperative evalution of patients with surgical mesh implants.