Pelvic floor ultrasound uses translabial (perineal) and endovaginal imaging to evaluate the muscles, ligaments, and connective tissue of the pelvic floor. It provides dynamic assessment of pelvic organ prolapse, urinary incontinence, and post-surgical anatomy that complements clinical examination and fluoroscopic defecography.
Sonographers image the levator ani muscle complex, urethral sphincter, and bladder neck at rest and during Valsalva and squeeze maneuvers. Levator ani avulsion injuries from childbirth, seen as detachment from the pubic bone, are diagnosed with translabial 3D/4D ultrasound. Cystocele, rectocele, enterocele, and uterovaginal prolapse are graded using standardized reference line systems.
Pelvic floor ultrasound is a subspecialty of gynecologic sonography, covered under the ARDMS OB/GYN specialty. It is performed in urogynecology clinics, pelvic floor physiotherapy centers, and tertiary referral hospitals. As pelvic floor disorders are increasingly recognized and treated with mesh implants and pelvic floor surgery, the demand for sonographers with this expertise is growing.