P07.06: Does a pelvic floor contraction change the appearance of EAS defects?

Abstract

On translabial ultrasound, a pelvic floor muscle contraction (PFMC) enhances visibility of levator defects. For this reason, exo-anal sphincter imaging is also performed on PFMC. We hypothesised that a PFMC may enlarge the defect, hence making it easier to visualise. This is a retrospective study analysing 842 archived datasets of women presenting at a tertiary urogynecological unit between January 2014 and December 2015. All patients underwent a standardised questionnaire, clinical examination and 4D trans-perineal ultrasound (TPUS). Tomographic ultrasound imaging (TUI) was used to evaluate the external anal sphincter at rest and on PFMC. The size of a defect was defined by measuring sector angles. Of 842 women, mean age was 54 (16-84) years. 89 % (751) were vaginally parous with median parity of 2 (1-8). The mean EAS defect angles at rest and on PFMC were 35.7o (2.5-142.8) and 34.9o (1.8-131.3) respectively. Significant EAS trauma was diagnosed in 143 (18%) at rest and 120 (14%) on PFMC. Figure 1 shows a comparison of defect angles at rest and on PFMC for positive slices 1-6. Contrary to expectations, the defect angle showed a reduction by 5-10 degrees on PFMC when comparing defect angle in women who had defects both at rest and on PFMC. Supporting information can be found in the online version of this abstract Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.