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Abstract Pelvic floor dysfunction usually leads to structural alterations in all compartments of the female pelvis. In advanced cases, with involvement of more than one compartment, accurate identification of all structures is essential to surgical planning and success. Clinical diagnosis may be difficult so an examination that provides a wide and simultaneous evaluation of all pelvic regions is highly desirable. In the past, dynamic contrast radiography (i.e., colpocystodefecography) has provided the only means of determining the inter-relationships which occur among pelvic organs in most common dysfunctions including double incontinence, obstructed defecation and pelvic prolapse. Conversely, due to its non-invasiveness, rapidity and the absence of ionizing radiation, ultrasonography of the pelvic floor, either by the transperineal or the endovaginal/introital approach, has been successfully employed in a number of gynaecological and nongynecological conditions. Currently, it is considered the examination of choice to start with in the diagnostic workup of urinary incontinence and genital prolapse. Perineal sonography can well evaluate the morphology of lower urinary tract including position of bladder neck and bladder base at rest and straining, rotation of alpha and beta angles and differentiate between anatomic incontinence and intrinsic sphincter deficiency. Perineal sonography can distinguish between different forms of posterior compartement prolapse as true rectocele, perineal hypermobility and enterocele. It is also capable of reliably assessing the anal sphincter complex with precise measurements and optimal patient comfort. Pelvic floor ultrasound is a highly useful diagnostic tool for physicians dealing with pelvic floor disorders; this includes not just gynecologists, urologists, and radiologists, but also colorectal surgeons and gasteroenterologists. Current trends, i.e., the near universal introduction of 3\4 dimensional ultrasound, new software options, and increasing availability of training, will likely lead to more general acceptance of ultrasound as a standard diagnostic option in pelvic floor medicine. |