Functional Ultrasound: Functional Female Echo-Dynamic Study

Ultrasound (US) is a useful diagnostic support in the study of female cervico-urethral dynamics, especially during preoperative workup in patients with a prolapse. The method is very important also for postsurgical control. Regardless of the type of US technique used, some important qualitative and quantitative parameters have been defined in order to standardize studies of the female pelvic floor. Surface (transperineal or translabial) or endocavitary (transrectal, transvaginal, introital) probes can be used. One anatomical reference point that has a great importance because it is a fixed point against which hypermobility of the urethrovesical junction can be measured is the pubic arcuate ligament. This moderately hyperintense cartilage structure binds the two pubic bones that are seen at US examination as a hyperintense signal with a conic shadow, whereas this is not evident at the level of the pubic arcuate ligament. US is a valid alternative to radiological examinations (MRI, perineography, etc.) for the study of female cervico-urethral dynamics because it is highly reliable. Undoubtedly, thanks to the spread of endocavitary US techniques (transrectal and transvaginal) in recent years, there has been a marked reduction in the number of radiological examinations with contrast medium performed for this study, in both basal and dynamic conditions. Indeed, the multiplicity of US approaches now adopted has raised awareness of the need to establish universal standards for these examinations.