July 2018
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683 Reads
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1 Citation
Journal of Medicine Study & Research
The pelvic floor is a complex area, exhibiting diverse pathologies. Among the so-called emptying disorders is the Obstructive Defecation Syndrome (ODS). The diagnosis of the pelvic floor presents us with major challenges, as the anatomy of the region is complicated and the physiology is often difficult to understand. Previous investigation methods have included MR-defecography, classic defecography, uro-gynecological examinations, proctological examinations, scores etc. Ultrasound examination of the pelvic floor is unlikely to be sufficiently established for some time. The examiner’s interpretation dependency and the lack of anatomical landmarks are challenging, which detracts from the significance of the investigation. The aim of this descriptive measurement study is to develop and describe a unique and reliable method for the assessment and quantification of all pelvic floor changes from the group of obstructive defecation disorders. This method should be applied to all affected patients regardless of their age, size, weight, whether they suffer from minor diseases, and/or after surgery, and should deliver reliable and unique data. It should provide a diagnosis without any interpretation from the examiner. Material and method: After anamnesis with detection of clear symptoms of obstructive defecation syndrome (incomplete evacuation, constipation, foreign body sensation etc.,) and clinical examination a consent to perform a pelvic floor sonography was obtained from all patients. To describe the measurement points we perform the examination for this study in primarily 25 women presenting obstructive defecation syndrome. In all examined patients, eight clearly defined measuring points were developed which can be found reliable at transperineal sonographic represented pelvic floor. These serve as a basis for the distance measurements in either a supine or a sitting position. The examinations were performed with an ultrasound scanner BK ProFocus ultra view, first supine and then in a sitting position. This resulted in selected measurement points and distances that were found in all the patients, and in both positions. Conversion of the absolute values as percentage changes allows for reliable diagnosis. Our study shows, in conclusion, that the new method of Transperineal Ultrasound Measurement on the Pelvic Floor (TUMPF) allows a reliable and unambiguous diagnosis in either the supine or the sitting position, whereby dependence on the ultrasound examiner can be avoided.