Functional Ultrasound: Functional Female Dynamic Ultrasonography Study

Ultrasound (US) is a useful diagnostic tool to study the female cervico-urethral dynamics, particularly in the preoperative assessment of patients with a prolapse. Its significance extends to postoperative monitoring as well. Regardless of the type of US technique used, some important qualitative and quantitative parameters have been defined to standardize studies of the female pelvic floor. Both surface (transperineal or translabial) and endocavitary (transrectal, transvaginal, introital) probes can be used. A pivotal anatomical reference point, crucial for measuring the hypermobility of the urethrovesical junction, is the pubic arcuate ligament (APL) or inferior pubic ligament. This moderately hyperintense cartilage structure binds the two pubic bones that are seen at US examination as a hyperintense signal with a strong conic shadow that is not evident at the level of the pubic arcuate ligament. US proves to be a reliable alternative to radiological examinations (such as MRI or perineography) for studying female cervico-urethral dynamics. The introduction of endocavitary US techniques (transrectal and transvaginal) in recent years has significantly reduced the reliance on contrast medium-based radiological studies, both in baseline and dynamic conditions. The growing variety of US approaches emphasizes the importance of establishing universal standards for these examinations.