Pelvic floor muscle dysfunction on 3D/4D transperineal ultrasound in patients with deep infiltrating endometriosis: a pilot study

Diego Raimondo, A Youssef, Mohamed Mabrouk, M Mabrouk, Simona Del Forno, S Del Forno, V Martelli, Valentina Martelli, G Pilu, N Rizzo, L Zannoni, Letizia Zannoni, Roberto Paradisi, R Paradisi, Renato Seracchioli, R Seracchioli
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2016 · vol. 50(4) , pp. 527–532 · doi:10.1002/uog.17323 · PMID:27718502 · W2528241499
article OA: bronze CC0 ⤵ 22 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

Women with deep infiltrating endometriosis showed smaller levator hiatal areas at rest and during Valsalva maneuvers, with less reduction during contraction and less enlargement during Valsalva compared to controls.

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Abstract

OBJECTIVE: Pelvic floor muscle (PFM) dysfunction seems to play an important role in the pathophysiology of pelvic pain, including that associated with deep infiltrating endometriosis (DIE). The aim of this study was to evaluate the static and dynamic morphometry of the PFM using three-dimensional (3D) and four-dimensional (4D) transperineal ultrasound in women with DIE compared with asymptomatic healthy women. METHODS: This was a pilot, prospective study conducted at our tertiary center between March and November 2015. Fifty nulliparous women with DIE (study group) and 35 nulliparous asymptomatic healthy women (control group) were included. 3D/4D transperineal ultrasound examination of the PFM was performed in both groups. Levator hiatal area (LHA) and anteroposterior and left-right transverse diameters were evaluated at rest, on maximum PFM contraction and on maximum Valsalva maneuver. Persistent levator ani muscle (LAM) coactivation during Valsalva maneuver was investigated. RESULTS: Compared with the control group, women with DIE had a smaller LHA at rest (P = 0.03) and during Valsalva maneuver (P < 0.01). Furthermore, reduction in LHA during PFM contraction (P < 0.001) and enlargement in LHA during Valsalva maneuver (P = 0.01) were significantly less marked. In comparison with controls, women with DIE presented a higher frequency of LAM coactivation during Valsalva maneuver, although this difference did not reach statistical significance (P = 0.05). CONCLUSIONS: 3D and 4D transperineal ultrasound is an objective and non-invasive method for PFM morphometry and may have a role in detecting PFM dysfunction in women with DIE. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

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Condition tags

mesh:D004715endometriosisdie_deep_infiltrating

MeSH descriptors

Endometriosis Imaging, Three-Dimensional Imaging, Three-Dimensional Muscle Contraction Pelvic Floor Ultrasonography Valsalva Maneuver Adult Endometriosis Endometriosis Female Humans Muscle Contraction Pelvic Floor Pelvic Floor Pilot Projects Prospective Studies Reproducibility of Results Valsalva Maneuver

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (29)

Cited by (22)

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