Related Experiment Video
Updated: Apr 15, 2026

Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
Published on: April 17, 2019
Can 3D power Doppler identify levator ani vascularization at its pubic insertion?
J Cassadó Garriga1, L Quintas Marques, A Pessarrodona Isern
1Department of Obstetrics and Gynecology, University Hospital Mútua Terrassa, Plaça Doctor Robert, 5, Terrassa, 08221, Spain, jcassado@gmail.com.
Introduction And Hypothesis:
The levator ani is the most important muscle in the pelvic floor. This pilot study using 3D power Doppler aimed to identify normal vascularization of the puborectalis/pubovisceralis muscle at its insertion in nulliparous and premenopausal women.
Methods:
Forty nulliparous and premenopausal women were evaluated at the Gynecological Unit of a tertiary hospital. All women underwent a translabial ultrasound (US) with 3D power Doppler. Pubic insertion of the puborectalis/pubovisceralis muscle was assessed in the axial plane, and vascularization index (VI), flow index (FI), and vascularization-flow index (VFI) were calculated bilaterally. Volumes were analyzed offline by two independent observers, and interobserver agreement and correlation between variables was calculated.
Results:
A high, statistically significant, correlation was found between the three US indices on each side (p < 0.005). No correlation was found between the US index and either of the demographic parameters of body mass index [(BMI), p > 0.241], or age (p > 0.398). The degree of correlation between the same index on the different sides was not statistically significant.
Conclusion:
Puborectalis/pubovisceralis muscle vascularization at its insertion can be identified using 3D Doppler US, but values differ substantially from those of the contralateral side.
Related Concept Videos
Muscles of the Pelvic Floor and Perineum
Perineal Layer
The perineum is a diamond-shaped area below the pelvic diaphragm, divided into an anterior urogenital triangle that contains the external genitals and a posterior anal triangle housing the anus. The urogenital...
Veins of the Abdomen and Pelvis
The inferior vena cava is fed by numerous smaller veins. The lumbar veins, for instance, drain the posterior abdominal wall, emptying both directly into the inferior vena cava and into the...
Assessment of the Abdomen III: Palpation
Anatomy of the Genitourinary System II: Bladder and Urethra
Ultrasound II: Endoscopic Ultrasound and FibroScan
Endoscopic Ultrasound (EUS):
Abdominal Aorta
The celiac trunk, a singular artery, divides into the left gastric artery, which...

