Pelvic Floor Ultrasound: Principles, Applications and Case Studies PDF
Preview Pelvic Floor Ultrasound: Principles, Applications and Case Studies
Pelvic Floor Ultrasound Principles, Applications and Case Studies Lewis Chan Vincent Tse Stephanie The Peter Stewart Editors 123 Pelvic Floor Ultrasound Lewis Chan (cid:129) Vincent Tse Stephanie The (cid:129) Peter Stewart Editors Pelvic Floor Ultrasound Principles, Applications and Case Studies Editors Lewis Chan Vincent Tse Department of Urology Department of Urology Concord Repatriation General Hospital Concord Repatriation General Hospital Sydney , New South Wales , Australia Sydney , New South Wales , Australia Stephanie The Peter Stewart Department of Women’s Department of Colorectal Surgery and Children’s Health Concord Repatriation General Hospital Pelvic Floor Unit Sydney , New South Wales , Australia Westmead Hospital Sydney , New South Wales , Australia ISBN 978-3-319-04309-8 ISBN 978-3-319-04310-4 (eBook) DOI 10.1007/978-3-319-04310-4 Library of Congress Control Number: 2015932253 Springer Cham Heidelberg New York Dordrecht London © Springer International Publishing Switzerland 2015 T his work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifi cally for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher’s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. T he use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer International Publishing AG Switzerland is part of Springer Science+Business Media (www.springer.com) Foreword All you wanted to know about pelvic fl oor ultrasound….and more! This very focused book on Pelvic Floor Ultrasound was designed with the clinician in mind. There is no doubt that the pelvic fl oor area crosses many health profession- als, including urologists, gynecologists, colorectal surgeons and physical therapists to name a few. The fi eld has expanded so much that female pelvic medicine and reconstructive surgery is now a new sub-specialty with its own certifi cation process in the United States. Almost all experts in the area of FPMRS will need more than fi ndings on clinical history and examination to better investigate and understand the key organs and pelvic structure beyond the confi nes of the vagina. Ultrasound is a safe technology, which is operator dependent both in terms of performance and interpretation. Trained eyes can see pelvic fl oor disorders that others won’t. This book is the best available resource so far to take the novice and experts alike through the unique features of this important imaging modality. The authors have conducted workshops on pelvic fl oor imaging using ultrasound the world over. They are staunch advocates of the integration of this modality into our clinician practice. T he structure of this book is very simple, practical, and hands-on. The fi rst chap- ters are dedicated to the principles of ultrasound and to ultrasound instrumentation. The ensuing chapters address practical aspects such as choosing your ultrasound equipment, setting up your ultrasound room, and clearing the accreditation pro- cesses. Next, the authors, with their broad expertise in urology, colorectal surgery and gynecology, take on the tasks of covering male and female voiding dysfunction, pelvic organ prolapse and fecal incontinence. Finally the book ends on a ninth chap- ter focusing on 3D ultrasound. Each chapter has a unique structure including case studies, practical tips presented in table format, and short video clips to illustrate real-time imaging fi ndings. As the result of the authors’ expertise, teaching skills honed through years of giving courses on pelvic fl oor imaging, and daily incorporation of pelvic fl oor ultra- sound in their clinical practice, the reader will fi nd this book very approachable, extremely resourceful, and utterly relevant. v vi Foreword S o here it is…pelvic ultrasound imaging at your fi ngertips! Yes, this book will convince you to incorporate this procedure in your practice. Yes, it will serve as an extension of what your fi ngers cannot touch or appreciate beyond the wall of the vagina. Yes, it will benefi t your patients and make you better clinicians. Yes, it may change completely your diagnostic accuracy and likely will alter your management plans. At the very least, it will make you more appreciative of the enormous poten- tials of this safe, well-established, yet technically evolving technology. Enjoy your reading…and then get started! Philippe Zimmern, MD, FACS Professor, Department of Urology Jane and John Justin Distinguished Chair in Urology, University of Texas Southwestern Medical Center Dallas , Texas , USA Pref ace Urinary incontinence, faecal incontinence and pelvic organ prolapse are signifi cant health problems. Patients may come under the care of many different health profes- sionals including urologists, gynaecologists, colorectal surgeons and physiotherapists. There is increasing interest in using ultrasound for assessment of pelvic fl oor dysfunction, and clinicians are uniquely placed to utilize this dynamic form of imaging. The urologist, gynaecologist and colo-rectal surgeon with a good understanding of the structure and function of the pelvic organs can integrate the clinical presentation, functional studies (e.g. urodynamics/ anorectal physiol- ogy) with imaging to provide better assessment and care for the patient. Whilst ultrasound equipment is widely available around the world, many clinicians may not have access to structured training in the technique of pelvic fl oor imaging and interpretation of images in the context of pelvic fl oor dysfunction. This book is written for clinicians who wish to explore the technique which is really an extension of clinical examination of the patient. There are step-by-step guides to starting up in performing pelvic fl oor ultrasound and tricks of the trade ‘tips’ in how to obtain good images. We have included case studies of common condi- tions to illustrate the role of ultrasound in assisting the clinician to manage pel- vic fl oor disorders and the benefi ts of incorporating ultrasound imaging into one’s clinical practice. There is an introduction to the 3D ultrasound techniques for the interested clinician wishing to take advantage of this emerging modality which is of increasing relevance in the management of complex pelvic fl oor dysfunction. G ood quality images are key to allow accurate interpretation of imaging fi ndings. The editors are indebted to Dr. Fulgham, the previous Chair of the American Urological Association Urologic Ultrasound Faculty, for contributing the introduc- tory chapters on the basic principles of ultrasound and techniques for optimizing the ultrasound image which are the important pre-requisites to performing clinician- performed ultrasound. vii viii Preface We hope the contents of this book will encourage you and provide the basis for starting your journey in ultrasound of the pelvic fl oor! Sydney, Australia Lewis Chan November 2014 Vincent Tse Stephanie The Peter Stewart Contents 1 The Physics and Technique of Ultrasound. . . . . . . . . . . . . . . . . . . . . . 1 Pat F. Fulgham 2 Machine Settings and Technique of Image Optimization. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Pat F. Fulgham 3 Essentials for Setting Up Practice in Clinician Performed Ultrasound. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Lewis Chan 4 Ultrasound Imaging in Assessment of the Male Patient with Voiding Dysfunction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Lewis Chan, Tom Jarvis, Stuart Baptist, and Vincent Tse 5 Pelvic Ultrasound in the Assessment of Female Voiding Dysfunction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 Lewis Chan 6 Practical Application of Ultrasound in the Assessment of Pelvic Organ Prolapse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Vincent Tse and Lewis Chan 7 Ultrasound Imaging of Gynaecologic Organs. . . . . . . . . . . . . . . . . . . 87 Stephanie The 8 Endoanal Ultrasound of Pelvic Floor. . . . . . . . . . . . . . . . . . . . . . . . . . 109 Peter Stewart 9 Principles and Applications of 3D Pelvic Floor Ultrasound . . . . . . . 125 Shelley O’Sullivan, Vincent Tse, Stephanie The, Lewis Chan, and Peter Stewart Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 ix
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