Levator Plate Upward Lift on Dynamic Sonography and Levator Muscle Strength.

Area of Science:

• Pelvic Floor Imaging
• Musculoskeletal Ultrasound
• Female Pelvic Medicine

Background:

• Pelvic floor muscle dysfunction affects many women, impacting quality of life.
• Accurate assessment of pelvic floor muscle strength is crucial for diagnosis and treatment.
• Digital palpation is a common but subjective method for assessing muscle strength.

Purpose of the Study:

• To compare digital palpation with dynamic sonography for measuring levator plate lift.
• To evaluate the correlation between levator plate lift measured by endovaginal and transperineal sonography and muscle strength assessed by the Modified Oxford Scale.

Main Methods:

• Dynamic transperineal and endovaginal sonography were used to assess levator plate movement during Kegel contractions.
• Levator plate lift and lift/rest ratio were calculated from sonographic measurements.
• Pelvic floor muscle strength was graded using the Modified Oxford Scale via digital palpation.

Main Results:

• A greater levator plate lift ratio measured by endovaginal sonography correlated with higher Modified Oxford Scale scores.
• Women with functional muscle strength (Modified Oxford Scale 2-5) showed significantly higher mean lift (4.6 mm) and lift/rest ratio (20%) compared to nonfunctional groups.
• A lift of 30% or greater on endovaginal sonography indicated functional muscle strength.

Conclusions:

• Dynamic endovaginal sonography provides a quantifiable measure of levator plate lift.
• This sonographic measurement is associated with pelvic floor muscle strength determined by digital palpation.
• Levator plate lift ratio via endovaginal sonography can be integrated into clinical assessments of levator ani function.