Comparison between pelvic floor ultrasound and physical examination in the evaluation of cystocele

Abstract

The main aim of this study was to explore the agreement between physical examination and ultrasound findings in the assessment of cystocele. It was a prospective observational study of women with primary cystocele. It enrolled 54 patients who underwent an interview, physical examination and 2D/3D transperineal ultrasound. The study included two observers: one who conducted the interview and carried out the examination, and another who performed the transperineal ultrasound. There was a concordance of 51.8% between examination and ultrasound concerning cystocele grading. In paravaginal defects, the concordance was 46.3%. In 42.6% of the patients, the ultrasound yielded better results for diagnosing paravaginal defect than the physical examination. Ultrasound revealed that levator ani muscle avulsion was present in 60.4% of patients and hiatal ballooning in 69.8%. In conclusion, the main utility of transperineal ultrasound is the evaluation of levator ani muscle integrity and urogenital hiatus through the axial plane in 3D.