Incidence Of Pelvic Floor Disorders Research Articles

Evaluation of Factors Affecting the Reduction in Postpartum Pelvic Floor Muscle Tension and The Therapeutic Effect

Purpose: This study investigated the risk factors associated with reductions in postpartum pel-vic floor muscle tension and evaluated improvements in pelvic floor muscle tension with electrical stimulation combined with biofeedback technology and Kegel exercis-es. Methods: We conducted a case-control study of 170 women with postpartum follow-up at Ningbo Li Huili Hospital from April 2019 to May 2020. According to the Oxford modified scale assessment(MOS), 94 and 76 women were included in the abnormal pelvic floor muscle tension group and control group, respectively. The two groups were trained by pelvic floor training. The changes in pelvic floor muscle tension before and after treatment in the two groups were analyzed to evaluate the effect of postpartum pelvic floor rehabilitation training. Results: The EMG value of the fast muscle contraction stage was negatively correlated with age and neonatal weight (P <0.05). The EMG values of slow muscle contraction and endurance were negatively correlated with weight gain during pregnancy but posi-tively correlated with age and BMI at delivery (P <0.05). The muscle tension of the abnormal muscle tension group was significantly improved and significantly higher than that of the control group (P <0.05) after the two groups received the intervention. Conclusion: The factors affecting postpartum pelvic floor muscle tension include age, delivery times, BMI at delivery and neonatal weight. Electrical stimulation combined with the biofeedback technique and Kegel exercises in the early postpartum period are effec-tive means to reduce the incidence of Pelvic floor disorders.

Functional Changes of the Genitourinary and Gastrointestinal Systems before and after the Treatment of Endometrial Cancer-A Systematic Review.

Simple SummaryEndometrial cancer is currently one of the most common gynecological cancer and accounts for around 5% of all female cancers. The treatment strategy most often includes surgery and adjuvant radiation therapy. Thanks to the high effectiveness of used treatment methods, the patients can live longer lives. Unfortunately their quality of life can be negatively affected by side effects resulting from weakening pelvic floor such as urinary incontinence, pelvic organ prolapse and fecal incontinence. In our paper we analyzed the studies published between 2010 and 2020 that touch upon the prevalence and management of pelvic floor dysfunction in endometrial cancer patients. Our results show increase in the incidence of pelvic floor disorders after various forms of endometrial cancer treatment and the need for more good quality research in the subject to be able to provide patients with holistic care focused on minimizing treatment side effects and prioritizing their quality of life.The incidence of endometrial cancer (EC), which coexists with such civilization diseases as diabetes, obesity or hypertension, is constantly increasing. Treatment includes surgery as well as brachytherapy, teletherapy, rarely chemotherapy or hormone therapy. Due to the good results of the treatment, the occurrence of side effects of therapy becomes a problem for the patients. One of the large groups of side effects includes the pelvic organ prolapse, urinary and fecal incontinence. The aim of this study was to present current knowledge on the occurrence of pelvic floor dysfunction in women treated for EC. A literature review was conducted in the PubMED and WoS databases, including articles on pelvic floor dysfunction in women with EC. PRISMA principles were followed in the research methodology. A total of 1361 publications were retrieved. Based on the inclusion and exclusion criteria, 24 papers were eligible for the review. Mostly retrospective studies based on different questionnaires were evaluated. No prospective studies were found in which, in addition to subjective assessment, clinical examination and objective assessment of urinary incontinence were used. Studies show a significant increase in the incidence of pelvic floor disorders, including urinary incontinence, after various forms of EC treatment. We believe that assessment of complications after endometrial cancer treatment is clinically relevant. The review emphasizes the importance of programming prospective studies to prevent and address these disorders at each stage of oncologic treatment.

Related Risk Factors for Pelvic Floor Disorders in Postpartum Women: A Cross-sectional Study

Objectives: Pelvic floor disorders (PFDs) during pregnancy and after delivery, and related risk factors are still debatable topics for research. Thus, the aim of the present study was to assess the probable risk factors associated with PFDs in Iran. Materials and Methods: This cross-sectional study was conducted in two state and private hospitals in Tabriz, Iran from the 1st of June to the 31st of August, 2018. The participants were 650 postpartum women, aged between 15 and 47 years six months after delivery. The type of delivery, type of hospital, history of episiotomy and induction, anesthesia, multiparity, the mother’s birth age, the infant’s weight and head circumference, the mother’s weight gain during pregnancy, and a wide variety of probably related risk factors were studied based on the study objective. According to their answer to the questions of PFDs, 147 women responded yes and completed the Pelvic Floor Distress Inventory-20 questionnaire. Results: Between the investigated risk factors, type of the hospital (OR: 0.27, CI: 0.126-0.564) and the amount of the mother’s weight gain during pregnancy (OR: 1.066, CI: 1.024-1.109) were significantly associated with PFDs. Finally, the number of PFDs and severity of dysfunctions according to PFDI-20 were higher in state hospitals, and excessive weight gain of the mother during pregnancy was related to the higher incidence of PFDs. Conclusions: Type of the hospital and the mother’s weight gain during pregnancy are the only two related risk factors in this study. This study was the first one to discuss the type of the hospital in such related risk factor studies. Accordingly, it is predictable that better supervision of medical attends in state hospitals is highly important for decreasing the rate of PFDs after delivery.

Incidence of Pelvic Floor Disorders in US Army Female Soldiers

To determine the incidence of pelvic floor disorders (PFD) among active-duty US Army female soldiers. We studied 102,015 women for incident PFD using the Stanford Military Data Repository, which comprises medical, demographic and service-related information on all soldiers on active duty in the US Army during 2011-2014. Cox proportional hazards estimated adjusted associations with PFD diagnoses. In the adjusted models, military-specific characteristics and fitness were evaluated alongside known PFD predictors. Among 102,015 subjects at risk there was a cumulative incidence of 6.4% over a mean of 27 months (median 29, range 1-42). In adjusted models, obese soldiers were more likely to have a PFD compared to those of normal weight (hazard ratio [HR] 1.23, confidence interval [CI] 1.14-1.34, P <0.001) and those with recent weight gain were more likely to have a PFD compared to those without (HR 1.32, CI 1.24-1.40, P <0.05). Women with the lowest physical fitness scores were more likely to have a PFD (HR 1.14, CI 1.04-1.25) compared to those with the highest scores. Over a median follow-up time of 29 months, 1 in 15 women in this active-duty cohort was diagnosed with a PFD. Optimizing risk factors including body mass index and physical fitness may benefit the pelvic health of female soldiers, independent of age, children, and years of service.

Pelvic floor muscle strength and the incidence of pelvic floor disorders after vaginal and cesarean delivery

Pelvic floor disorders (including urinary and anal incontinence and pelvic organ prolapse) are associated with childbirth. Injury to the pelvic floor muscles during vaginal childbirth, such as avulsion of the levator ani muscle, is associated with weaker pelvic floor muscle strength. As weak pelvic floor muscle strength may be a modifiable risk factor for the later development of pelvic floor disorders, it is important to understand how pelvic floor muscle strength affects the course of pelvic floor disorders over time. To investigate the association between pelvic floor muscle strength and the incidence of pelvic floor disorders, and to identify maternal and obstetrical characteristics that modify the association. This is a longitudinal study investigating pelvic floor disorders after childbirth. Participants were recruited 5-10 years after their first delivery and were assessed for pelvic floor disorders annually for up to 9 years. Stress incontinence, overactive bladder, and anal incontinence were assessed at each annual visit using the Epidemiology of Prolapse and Incontinence Questionnaire. Pelvic organ prolapse was assessed on physical examination, and was defined as descent of the vaginal walls or cervix beyond the hymen during forceful Valsalva. The primary exposure of interest was pelvic floor muscle strength, defined as the peak pressure during a voluntary pelvic muscle contraction (measured with a perineometer). The relationship between pelvic floor muscle strength and the cumulative incidence (time to event) of each pelvic floor disorder was evaluated using lognormal models, stratified by vaginal vs cesarean delivery. The relative hazard for each pelvic floor disorder (among those women free of the disorder at enrollment and thus more than 5-10 years from first delivery), was estimated using semiparametric proportional hazard models as a function of delivery mode, pelvic floor muscle strength, and other covariates. Of 1143 participants, the median age was 40 (interquartile range, 36.6-43.7) years, and 73% were multiparous. On perineometry, women with at least 1 vaginal delivery were more likely to have a low peak pressure, defined as <20 cm H2O (243 of 588 women with at least 1 vaginal delivery vs 107 of 555 women who delivered all of their children by cesarean delivery, P < .001). Among women who had at least 1 vaginal delivery, a pelvic floor muscle strength of <20 cm H2O was associated with a shorter time to event for stress incontinence (time ratio, 0.67; 95% confidence interval, 0.50-0.90), overactive bladder (time ratio, 0.67; 95% confidence interval, 0.51-0.86), and pelvic organ prolapse (time ratio, 0.76; 95% confidence interval, 0.65-0.88). No such association was found among women who delivered all of their children by cesarean delivery. Among women with at least 1 vaginal delivery and considering only pelvic floor disorders that developed during study observation (5-10 years after the first delivery), and controlling for maternal characteristics (body mass index and genital hiatus), women who had a peak pressure of <20 cm H2O had hazard ratios (relative to ≥20 cm H2O) of 1.16 (95% confidence interval, 0.74-1.81) for stress incontinence, 1.27 (95% confidence interval, 0.78-2.05) for overactive bladder, and 1.43 (95% confidence interval, 0.99-2.07) for pelvic organ prolapse. Among women who delivered all of their children by cesarean delivery, there was no association between muscle strength and relative hazard of pelvic floor disorders when controlling for maternal characteristics. After vaginal delivery, but not cesarean delivery, the cumulative incidence of pelvic organ prolapse, stress incontinence, and overactive bladder is associated with pelvic muscle strength, but the associations attenuate when adjusting for genital hiatus and body mass index.

Pelvic Floor Disorders After Obstetric Avulsion of the Levator Ani Muscle.

With vaginal childbirth, 10% to 30% of women sustain levator ani muscle avulsion. The objective of this study was to estimate the cumulative incidence of prolapse and other pelvic floor disorders (PFDs), comparing vaginally parous women with and without levator avulsion. Parous women enrolled in a longitudinal study were assessed annually for PFDs with the Pelvic Organ Prolapse Quantification Examination (for prolapse) and the Epidemiology of Prolapse and Incontinence Questionnaire (for stress incontinence, overactive bladder, and anal incontinence). Three-dimensional transperineal ultrasound was used to identify levator avulsion. Women with and without levator avulsion after vaginal delivery were compared for the cumulative incidence of PFDs. Further analysis also stratified by forceps delivery. At the time of assessment, 453 participants were 6 to 17 years from first delivery (median, 11 years). Levator avulsion was identified in 15% (66/453) and was more common among those who had undergone forceps-assisted delivery (P < 0.001). Levator avulsion was strongly associated with prolapse beyond the hymen (odds ratio, 2.7; 95% confidence interval, 1.3-5.7) and with symptoms of prolapse (odds ratio, 3.0; 95% confidence interval-1.2, 7.3). These associations persisted after controlling for forceps-assisted delivery. In contrast, the odds of stress incontinence, overactive bladder, and anal incontinence were marginally (but not significantly) increased among women with levator avulsion in this cohort. Obstetric levator avulsion is strongly associated with pelvic organ prolapse. The relationship between levator avulsion and other PFDs may not be significant.

Association of Delivery Mode With Pelvic Floor Disorders After Childbirth

Pelvic floor disorders (eg, urinary incontinence), which affect approximately 25% of women in the United States, are associated with childbirth. However, little is known about the course and progression of pelvic floor disorders over time. To describe the incidence of pelvic floor disorders after childbirth and identify maternal and obstetrical characteristics associated with patterns of incidence 1 to 2 decades after delivery. Women were recruited from a community hospital for this cohort study 5 to 10 years after their first delivery and followed up annually for up to 9 years. Recruitment was based on mode of delivery; delivery groups were matched for age and years since first delivery. Of 4072 eligible women, 1528 enrolled between October 2008 and December 2013. Annual follow-up continued through April 2017. Participants were categorized into the following mode of delivery groups: cesarean birth (cesarean deliveries only), spontaneous vaginal birth (≥1 spontaneous vaginal delivery and no operative vaginal deliveries), or operative vaginal birth (≥1 operative vaginal delivery). Stress urinary incontinence (SUI), overactive bladder (OAB), and anal incontinence (AI), defined using validated threshold scores from the Epidemiology of Prolapse and Incontinence Questionnaire, and pelvic organ prolapse (POP), measured using the Pelvic Organ Prolapse Quantification Examination. Cumulative incidences, by delivery group, were estimated using parametric methods. Hazard ratios, by exposure, were estimated using semiparametric models. Among 1528 women (778 in the cesarean birth group, 565 in the spontaneous vaginal birth group, and 185 in the operative vaginal birth group), the median age at first delivery was 30.6 years, 1092 women (72%) were multiparous at enrollment (2887 total deliveries), and the median age at enrollment was 38.3 years. During a median follow-up of 5.1 years (7804 person-visits), there were 138 cases of SUI, 117 cases of OAB, 168 cases of AI, and 153 cases of POP. For spontaneous vaginal delivery (reference), the 15-year cumulative incidences of pelvic floor disorders after first delivery were as follows: SUI, 34.3% (95% CI, 29.9%-38.6%); OAB, 21.8% (95% CI, 17.8%-25.7%); AI, 30.6% (95% CI, 26.4%-34.9%), and POP, 30.0% (95% CI, 25.1%-34.9%). Compared with spontaneous vaginal delivery, cesarean delivery was associated with significantly lower hazard of SUI (adjusted hazard ratio [aHR], 0.46 [95% CI, 0.32-0.67]), OAB (aHR, 0.51 [95% CI, 0.34-0.76]), and POP (aHR, 0.28 [95% CI, 0.19-0.42]), while operative vaginal delivery was associated with significantly higher hazard of AI (aHR, 1.75 [95% CI, 1.14-2.68]) and POP (aHR, 1.88 [95% CI, 1.28-2.78]). Stratifying by delivery mode, the hazard ratios for POP, relative to a genital hiatus size less than or equal to 2.5 cm, were 3.0 (95% CI, 1.7-5.3) for a genital hiatus size of 3 cm and 9.0 (95% CI, 5.5-14.8) for a genital hiatus size greater than or equal to 3.5 cm. Compared with spontaneous vaginal delivery, cesarean delivery was associated with significantly lower hazard for stress urinary incontinence, overactive bladder, and pelvic organ prolapse, while operative vaginal delivery was associated with significantly higher hazard of anal incontinence and pelvic organ prolapse. A larger genital hiatus was associated with increased risk of pelvic organ prolapse independent of delivery mode.

MP33-01 COST IMPACT OF ELECTIVE CESAREAN DELIVERY ON FUTURE PELVIC FLOOR DISORDERS

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Pelvic Prolapse1 Apr 2018MP33-01 COST IMPACT OF ELECTIVE CESAREAN DELIVERY ON FUTURE PELVIC FLOOR DISORDERS Devin Patel, Justin Houman, James Weinberger, Lauren Wood, Jennifer Anger, and Karyn Eilber Devin PatelDevin Patel More articles by this author , Justin HoumanJustin Houman More articles by this author , James WeinbergerJames Weinberger More articles by this author , Lauren WoodLauren Wood More articles by this author , Jennifer AngerJennifer Anger More articles by this author , and Karyn EilberKaryn Eilber More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1072AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We sought to analyze the cost impact of Cesarean versus spontaneous vaginal delivery on two common forms of pelvic floor disorders (PFDs): stress urinary incontinence (SUI) and pelvic organ prolapse (POP). METHODS We compared average cost of delivery method to the lifetime risk and cost of PFD in women <65 years of age. In this analysis, direct costs were defined based on reimbursements. Initial cost of maternal care included those incurred at delivery and three months post-partum. Future costs of PFD included those incurred after delivery up to 65 years of age. Costs of maternal care were obtained from MarketScan® databases of reimbursement. A previously reported incremental cost of illness model was used to estimate direct (inpatient and outpatient reimbursement and prescription drugs) and indirect (disability claims and imputed wages for work absence) costs for SUI. Personal costs for SUI (supplies, laundry, dry cleaning) were assumed for one year and estimated based on previous data. The cost of POP was determined by multiplying the number of POP operations by the direct costs per surgery. Previously reported data on incidence of POP and SUI in women following Cesarean and vaginal delivery was used to calculate attributable risk. RESULTS The average estimated cost for vaginal delivery was $7,089 and for Cesarean delivery was $9,905. For SUI, the average direct cost was estimated as $5,642, the average indirect cost as $4,208 and the average personal cost as $750. The average direct cost of POP surgery was $4,658. Following Cesarean delivery, the absolute risk for SUI and POP was estimated as 7% and 5%, respectively. Following vaginal delivery, the absolute risk for SUI and POP was estimated as 13% and 14%, respectively. The average woman undergoing Cesarean delivery would undergo an immediate excess cost of $2,816. The potential savings for SUI and POP in women <65 years of age would be $636 and $419, respectively, for a total of $1,055. CONCLUSIONS Although elective Cesarean is associated with reduced incidence of PFDs, the increased immediate cost of Cesarean delivery does not offset future cost savings. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e427-e428 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Devin Patel More articles by this author Justin Houman More articles by this author James Weinberger More articles by this author Lauren Wood More articles by this author Jennifer Anger More articles by this author Karyn Eilber More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Functional Evaluation of Obese Patients with Symptoms of Fecal Incontinence Using Anorectal Electromanometry

Obesity is a modifiable risk factor to fecal incontinence (FI) and weight loss result in improvement in the frequency and severity of FI. Introduction: Fecal incontinence (FI) has a multifactorial etiology and is most common in women. The prevalence is variable, though generally underestimated due to embarrassment. Since the incidence of pelvic floor disorders is higher among obese individuals, obesity may be considered a modifiable risk factor for FI. Weight loss seems to result in improvement in the frequency and severity of FI episodes. However, little has been published on FI in obese subjects and on its impact on quality of life in this patient population. Objective: Perform functional evaluations of obese patients with FI using anorectal electromanometry and determine the incidence of anismus. Materials and methods: Retrospective study including 58 obese subjects with FI aged 18-60 years. The patients were diagnosed clinically, and then submitted to physical examination followed by ARM. Results: The sample included 58 obese patients with an average BMI of 35 kg/m² (range: 30-52). The female gender was predominant: n=44 (75.87%) vs. male n=14 (24.13%). The average age was 49 years (23-60), the average pressure at rest was 49 mmHg (8-94) and the average pressure during straining was 124 mmHg (34-263). Half the patients (50%) presented hypotonia at rest and/or during straining, and 45% had anismus. Conclusion: Obesity is a modifiable risk factor for fecal incontinence, the etiology can be varied and needs to be established. In our results show that functional evaluation is necessary to determine the etiology of FI in obese patients and choose the best therapeutic approach in each case.

Effect of Estrogen on Molecular and Functional Characteristics of the Rodent Vaginal Muscularis

Vaginal atrophy is a consequence of menopause; however, little is known concerning the effect of a decrease in systemic estrogen on vaginal smooth muscle structure and function. As the incidence of pelvic floor disorders increases with age, it is important to determine if estrogen regulates the molecular composition and contractility of the vaginal muscularis. The goal of this study was to determine the effect of estrogen on molecular and functional characteristics of the vaginal muscularis utilizing a rodent model of surgical menopause. Three- to 4-month old Sprague-Dawley rats underwent sham laparotomy (Sham, N = 18) or ovariectomy (Ovx, N = 39). Two weeks following surgery, animals received a subcutaneous osmotic pump containing vehicle (Sham, Ovx) or 17β-estradiol (Ovx). Animals were euthanized 1 week later, and the proximal vagina was collected for analysis of contractile protein expression and in vitro studies of contractility. Measurements were analyzed using a one-way analysis of variance followed by Tukey's post hoc analysis (α = 0.05). Protein and mRNA transcript expression levels of contractile proteins, in vitro measurements of vaginal contractility. Ovariectomy decreased the expression of carboxyl-terminal myosin heavy chain isoform (SM1) and h-caldesmon and reduced the amplitude of contraction of the vaginal muscularis in response to KCl. Estradiol replacement reversed these changes. No differences were detected in the % vaginal muscularis, mRNA transcript expression of amino-terminal MHC isoforms, l-caldesmon expression, and maximal velocity of shortening. Systemic estrogen replacement restores functional and molecular characteristics of the vaginal muscularis of ovariectomized rats. Our results indicate that menopause is associated with changes in the vaginal muscularis, which may contribute to the increased incidence of pelvic floor disorders with age.

Vaginal Childbirth and Pelvic Floor Disorders

Childbirth is an important event in a woman's life. Vaginal childbirth is the most common mode of delivery and it has been associated with increased incidence of pelvic floor disorders later in life. In this article, the authors review and summarize current literature associating pelvic floor disorders with vaginal childbirth. Stress urinary incontinence and pelvic organ prolapse are strongly associated with vaginal childbirth and parity. The exact mechanism of injury associating vaginal delivery with pelvic floor disorders is not known, but is likely multifactorial, potentially including mechanical and neurovascular injury to the pelvic floor. Observational studies have identified certain obstetrical exposures as risk factors for pelvic floor disorders. These factors often coexist in clusters; hence, the isolated effect of these variables on the pelvic floor is difficult to study.

Effect of estrogen on molecular and functional characteristics of the rodent vaginal muscularis

Vaginal atrophy is a consequence of menopause, however little is known concerning the effect of estrogen on vaginal smooth muscle function. The goal of this study was to determine the effect of estrogen on molecular and functional characteristics of the vaginal muscularis using a rodent model of surgical menopause. 3–4 month old Sprague Dawley rats underwent sham laparotomy (Sham) or ovariectomy (Ovx). Two weeks following surgery, animals received a subcutaneous osmotic pump containing vehicle (Sham, Ovx) or 17‐ β estradiol (Ovx). Animals were euthanized one week later and the proximal vagina was collected for molecular and in vitro contractility studies. Measurements were analyzed using one way ANOVA followed by post hoc analysis. Ovariectomy decreased 1) mRNA transcript (P&lt;0.05) and protein (P &lt; 0.001) expression of carboxyl‐terminal myosin heavy chain isoform (MHC), SM1, 2) protein expression of h‐caldesmon (P &lt; 0.01) and 3) peak force of vaginal strips in response to KCl (P &lt; 0.001). Estradiol replacement reversed these changes. No differences were detected in the % vaginal muscularis, amino terminal MHC isoform expression and maximal velocity of shortening. Our results suggest that menopause is associated with changes in the vaginal muscularis which may contribute to the increased incidence of pelvic floor disorders with age.Funding: AUA Research Scholar Award, Maureen Basha

Etiology & Treatment of Vault Prolapse – Recent Advances and Personal Experience

As life expectancy in a woman is increasing so is the incidence of pelvic floor disorders. The life time risk of surgery for pelvic prolapse or incontinence has been estimated at 11% with a reoperative rate for failure at 29%. To overcome this reoperative rate, understanding of the functional anatomy of the pelvic viscera and biomechanics of the pelvic support continues to evolve thereby innovating newer surgical techniques. In this article an insight will be given on some aspects of these recent advances. We present our personal experience with 22 patients of prolapse after treatment with Khanna's Sling operation. The operation was performed in 12 patients of vault prolapse as primary treatment and in 10 patients as prophylactic treatment.

Importância do ultra-som tridimensional na avaliação anorretal

Anorectal endosonography is actually the main image exam to evaluate some anorectal diseases. To show the three-dimensional endosonography importance in the anal canal anatomic evaluation and the anorectal diseases diagnosis. Seventy four anorectal ultrasound were performed, 23 normal individuals (13 women) and 51 patients (33 women) with benign and malignant diseases. All the patients were examined with a 3-D equipment with 360 degrees transducer. Normal individuals were evaluated in midline sagittal plane concerning to the length of the anal canal, the internal anal sphincter, the external anal sphincter and the anatomic defect in the anterior quadrant. There were no differences in the anal canal and the internal anal sphincter length between men and women. Otherwise, the external anal sphincter length is longer in men and the anatomic defect is longer in women. In those with anorectal diseases, 11 sphincter injuries, 8 anal fistulas, 7 abscess, 1 perirectal endometriosis, 1 pre-sacral cyst, 3 anal canal and 10 rectal malignant neoplasias were diagnosed. The surgical findings confirmed the ultrasound diagnosis in all the patients. Three-dimensional endosonography demonstrated the anatomic differences between male and female anal canal, justifying the larger incidence of pelvic floor disorders in female patients. It was possible to diagnose the anorectal diseases, in multi-plane, with high spatial resolution, adding also important informations about the therapeutic decision. Such characteristics become it similar to nuclear magnetic resonance with intra-rectal coil, with the advantages to be easier, quicker, low cost and better tolerated.