Imaging studies of the pelvic floor

A variety of imaging modalities complement the history and physical examination in the investigation of pelvic floor dysfunction in women. Current fluoroscopic techniques, including defocography, can reveal underlying pelvic floor defects by reproducing normal daily activities that cause symptoms. Magnetic resonance imaging provides fine musculoskeletal detail of this region in anatomic plane not well seen via computerized tomography. Ultrasound is used primarily in assessment of the anal sphincter muscles. Cystourethroscopy provides direct visualization of the lower urinary tract. This article describes the clinical applications and technique of each modality.