Functional assessment for incontinence
Urinary incontinence during coughing, laughing and physical activity is a common problem that women rarely talk about out loud. It is most often based on urethral hypermobility: weakened pelvic floor structures no longer hold the bladder neck and urethra in the correct position, and when intra-abdominal pressure increases, they shift downward.
Ultrasound of the pelvic floor is performed through the perineal or introital approach and evaluates these structures in dynamics. The position of the bladder neck at rest and during straining, the angle of inclination of the urethra, the degree of its displacement, and the presence of a funnel-shaped expansion of the internal opening are measured. These indicators help differentiate stress incontinence from overactive bladder, conditions with very different treatments.
At the same time, the sphincter apparatus of the rectum is examined: its integrity, the thickness of the internal and external sphincters, defects after birth injuries. Such defects often turn out to be the cause of gas and fecal incontinence, which patients are also reluctant to talk about, and identifying them directly determines the choice between conservative therapy and surgical restoration.
Ultrasound capabilities
Ultrasound remains the first choice for imaging in almost every situation: it is accessible, safe, does not require radiation, and provides images in real time. It perfectly shows parenchymal organs, fluid formations, walls of hollow organs and soft tissues, and in Doppler mode, blood flow in the vessels.
A separate advantage is the possibility of dynamic tests: the doctor can ask you to strain, change your body position, fill or empty an organ and see how the picture changes. Neither computed tomography nor magnetic resonance imaging provide such an opportunity.
What influences the quality of research
The main enemy of ultrasound is gas: it completely reflects the wave. Therefore, distended intestines can make the pancreas, aorta, and retroperitoneal structures invisible. For the same reason, preparation for examining the abdominal cavity is not a formality, but a condition for a reliable result.
Severe obesity, postoperative scars, bandages and open wounds in the area of interest also have an effect. If the picture turns out to be uninformative, the doctor indicates this in the protocol and recommends an alternative method - computed tomography or magnetic resonance imaging.
Doppler mode
Dopplerography shows the movement of blood: color mapping reflects the direction of flow, spectral analysis measures velocities and resistance indices. This allows you to assess the patency of the vessel, identify stenosis, thrombus, aneurysm, pathological reflux and the nature of the blood supply to the formation.
Increased blood flow in Doppler mode is an important sign of active inflammation or tumor growth, which is why many organ studies are supplemented with Doppler as a mandatory part of the protocol.