The clinical application of transperineal ultrasound in urogynaecology

Transperineal ultrasound allows reproducible imaging of pelvic floor conditions that aids in the thorough assessment required to diagnose and treat urogynaecological conditions. Views that can be obtained include two‐dimensional (2D) sagittal views of the bladder neck, urethra and pelvic floor; 2D coronal views of the anal canal; and three‐dimensional (3D) or four‐dimensional (4D) views of the genital hiatus and anal canal. This allows assessment of the post‐void residual volumes, detrusor wall thickness and dynamic assessment of the urethral morphology. Ultrasonographic assessment enables accurate information about maternal birth trauma to be ascertained, including levator ani muscle avulsion and obstetric anal sphincter injury. Transperineal ultrasound can be used to identify and assess previously implanted vaginal mesh and midurethral slings.