Ultrasound in Perineology

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Ultrasound in Perineology

• Understanding the function through the image
• Jacques Beco M.D.
• Groupement Européen de Périnéologie
• http//www.perineology.com

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The  Perineologist 

• Architect of the perineum.
• Perfect knowledge of the 3 axis anatomy.
• Holistic view of the woman.
• Needs  good eyes and good fingers 
• Learn with ULTRASOUND

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Aim of the lecture

• To show how ultrasound could study all the
  aspects
• of the perineum.
• It should become a teaching tool for the
  perineologists  eyes and fingers .

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The 3 Axis Anatomy
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Gross AnatomySagittal Section
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Gross AnatomySagittal Section
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Gross AnatomyIn practice

• 1. Effect of abdominal hyperpressure
• Rectocele, Cystocele, Enterocele
• Bladder neck descent
• Descending Perineum Syndrome
• Size of the  hiatus 
• 2. Effect of pubo-rectal contraction

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Gross AnatomySagittal Section
DPS
Normal
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Pubo-rectal MusclePara-sagittal section
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Pubo-rectal MusclePara-sagittal section
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Levator PlateSagittal section
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Levator PlateSagittal section
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Levator PlateSagittal section
DPS
Normal
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Levator Plate and AnusTransrectal lateral section
1 Internal Sphincter. 2 Smooth long m. 3
Base Loop 4 Intermediate Loop 5 Levator
plate 6 Top Loop (P.R.)
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Levator Plate and AnusTransrectal lateral section
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Anus and TransverseTransvaginal Cross-section
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Urethro-Vesical AreaSagittal section
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Urethro-Vesical AreaSagittal section
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Urethro-Vesical AreaSagittal sectionMain
applications

• 1. Stress incontinence
• Bladder neck descent
• Post-operative imaging
• 2. Urge incontinence
• Urethral instability
• Bladder instability
• 3. Voiding

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Urethro-Vesical AreaSagittal sectionPost-operati
ve imaging
Burch
M.V.T.
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Urethro-Vesical AreaSagittal sectionUrethral
Instability
Prepubic Sphincter Pubo-rectal
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Urethro-Vesical AreaUrethral InstabilitySection
of the Prepubic Muscle
Test Effect Section
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Urethro-Vesical AreaSagittal sectionDoppler
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Urethro-Vesical AreaSagittal sectionDoppler
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Urethro-Vesical AreaCross-Section
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Urethro-Vesical AreaM.V.T. Cross-Section
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Welcome in PerineologyUltrasound

• The images are on WWW.ultrasonography.org
• The video is on WWW.perineology.TV
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• PASSWORD ultrasound