3D ultrasound strain imaging of puborectal muscle with and without unilateral avulsion

Shreya Das, Gijs A.G.M. Hendriks, Frieda van den Noort, Claudia Manzini, C. H. van der Vaart, Chris L. de Korte*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

48 Downloads (Pure)


Introduction and hypothesis: The puborectal muscle (PRM), one of the female pelvic floor (PF) muscles, can get damaged during vaginal delivery, leading to disorders such as pelvic organ prolapse. Current diagnosis involves ultrasound (US) imaging of the female PF muscles, but functional information is limited. Previously, we developed a method for strain imaging of the PRM from US images in order to obtain functional information. In this article, we hypothesize that strain in the PRM would differ from intact to the avulsed end. Methods: We calculated strain in PRMs at maximum contraction, along their muscle fiber direction, from US images of two groups of women, which consisted of women with intact (n1 = 8) and avulsed PRMs (unilateral) (n2 = 10). Normalized strain ratios between both ends of the PRM (avulsed or intact) and the mid region were calculated. Subsequently, the difference in ratio between the avulsed and intact PRMs was determined. Results: We observe from the obtained results that the contraction/strain pattern of intact and undamaged PRMs is different from PRMs with unilateral avulsion. Normalized strain ratios between avulsed and intact PRMs were statistically significant (p = 0.04). Conclusion: In this pilot study, we were able to show that US strain imaging of PRMs can show differences between intact PRMs and PRMs with unilateral avulsion.

Original languageEnglish
Pages (from-to)2225-2233
Number of pages9
JournalInternational Urogynecology Journal
Issue number9
Early online date14 Apr 2023
Publication statusPublished - Sept 2023


  • UT-Hybrid-D
  • Ultrasound
  • Unilateral avulsion
  • Puborectal muscle


Dive into the research topics of '3D ultrasound strain imaging of puborectal muscle with and without unilateral avulsion'. Together they form a unique fingerprint.

Cite this