Rehabilitative Ultrasound Imaging as Visual Biofeedback in Pelvic Floor Dysfunction: A Narrative Review

Area of Science:

• Urology
• Physical Therapy
• Medical Imaging

Background:

• Pelvic floor dysfunction affects both genders, impacting sphincter control, sexual health, and causing pain.
• Pelvic floor muscle (PFM) training is a primary treatment for urinary incontinence.
• Rehabilitative ultrasound imaging (RUSI) offers real-time visual biofeedback to improve PFM training and adherence.

Purpose of the Study:

• To evaluate the role and efficacy of RUSI in pelvic floor rehabilitation.
• To synthesize evidence on RUSI's impact on PFM function and patient outcomes.

Main Methods:

• Narrative review of literature from PubMed, Cochrane, and MEDLINE up to July 2025.
• Prioritization of systematic reviews, meta-analyses, and clinical trials.
• Keywords: pelvic floor rehabilitation, ultrasound, biofeedback.

Main Results:

• Transperineal and transabdominal ultrasound improve PFM function in diverse populations.
• RUSI-guided training shows superior PFM contraction compared to verbal cues, aiding those with difficulty contracting.
• RUSI outcomes are comparable or superior to other biofeedback modalities, though evidence is limited by protocol standardization.

Conclusions:

• RUSI is an effective visual biofeedback tool for enhancing PFM training outcomes in pelvic floor rehabilitation.
• It aids clinical decisions and patient engagement, especially when traditional assessments are difficult.
• Further research with standardized protocols and comparative trials is needed to confirm RUSI's superiority and optimize its clinical use.