By Giulio Aniello Santoro
New 3-dimensional endoanal and endorectal ultrasonographic and magnetic resonance imaging innovations have given greater perception into the complicated anatomy of the pelvic ground and its pathologic amendment in benign anorectal illnesses. Obstetrical occasions resulting in fecal incontinence in ladies, the connection among fistulous tracks and the sphincter complicated, and mechanisms of obstructed defecation syndrome can now be effectively evaluated, that is of basic value for choice making. due to advancements within the analysis of those issues, new varieties of remedy were built with larger end result for patients.
This publication is geared toward common and colorectal surgeons, radiologists, gastroenterologists and gynecologists with a distinct curiosity during this box. it's also proper to every person who desires to increase their knowing of the elemental rules of pelvic ground issues.
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Best Pract Res Clinic Obstet Gynaec 18:157–173 Section III • State of the Art in Pelvic Floor Imaging 9. Santoro GA, Di Falco G (2004) Basic anatomy. In: Santoro GA, Di Falco G. Atlas of endoanal and endorectal ultrasonography. Springer Italy, Milan 10. Stoker J (2003) The anatomy of the pelvic floor and sphincters. In: Bartram CI, DeLancy JOL. Imaging Pelvic Floor Disorders. Springer, Berlin Heidelberg New York 11. Woodman PJ, Graney DO (2002) Anatomy and physiology of the female perineal body with relevance to obstetrical injury and repair.
Any IAS >4 mm thick should be considered abnormal whatever the patient’s age; conversely, a sphincter of 2 mm is normal in a young patient but abnormal in an elderly one. 6 mm in females. 1 mm in females. Many studies have specifically addressed the problems of the reproducibility of EAUS sphincter measurements [17, 18, 26–28]. Enck et al.  Fig. 20. The external sphincter can be sonographically identified as a structure with mixed echogenicity (arrows) Section III • State of the Art in Pelvic Floor Imaging 47 Longitudinal muscle Rectum Puborectalis Deep EAS } HIGH Superficial } Subcutaneus } LOW MID Fig.
However, it remains difficult to reliably measure this structure because of the lack of clear limits. Also, the proposed use of a finger introduced into the vagina as a landmark seems to be of poor benefit, altering its normal configuration due to the digital compression on the central perineum [24, 25]. Three-dimensional endosonography may provide accurate imaging of the perineal body in females and more accurate measurement (Fig. 26). The anococcygeal raphe is seen as a posterior hypoechoic triangle (Fig.