Translabial sonography in evaluating the lower female urogenital tract

Transvaginal sonography has become an invaluable technique for examining the uterus, adnexa, and other nongynecologic structures in the pelvis because it provides better spatial resolution than transabdominal sonography [1]. Transvaginal sonography is a technique that complements manometric urodynamic examination by permitting a precise study of periurethral soft tissue. However, the principal disadvantage of transvaginal sonography is the distortion it provokes in vesicourethral anatomy [2]. Furthermore, transvaginal sonography cannot be used in small girls, virgins, and women with narrow vaginas, nor can it be used in assessing incontinence and other voiding dysfunctions because of direct effects on the physiology of the urinary tract caused by the probe itself [3]. Translabial sonography, which we have routinely used since 1990 [4], is an excellent alternative means of examination for these patients and for disorders of the lower urogenital tract. We have used translabial sonography in different types of incontinence. To learn more about the physiology of micturition, using translabial sonography, we let patients micturate not only in a recumbent position but also standing while straining and coughing. The latter position simulates a provocative cystometry. In this paper, we describe the translabial sonographic technique and some of the disorders we have encountered.