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Use of Transabdominal Ultrasound Imaging in Retraining the Pelvic-Floor Muscles of a Woman Postpartum

A Ariail, PT, DPT, CLT, is Senior Physical Therapist, Rehabilitation Department, United General Hospital, 2000 Hospital Dr, Sedro-Woolley, WA 98284 (USA)
T Sears, PT, DPT, OCS, is Senior Physical Therapist and Instructor, Department of Physical Therapy and Athletic Training, Sargent College of Health and Rehabilitation, Boston University, Boston, Massachusetts
E Hampton, PT, BCIA-PMDB, is Owner and Senior Physical Therapist, Core Therapeutics Physical Therapy and Pilates Studio, Bellingham, Washington

Address all correspondence to Dr Ariail at: allison.ariail{at}unitedgeneral.org

Background and Purpose: Postpartum stress urinary incontinence (SUI) often compromises a woman's ability to participate in normal daily routines or physical activities. Pelvic-floor muscle (PFM) training has been shown to be effective in improving urinary incontinence. Transabdominal ultrasound (TAUS) imaging is a new, noninvasive method for assessing the function of the PFMs. This case report describes the use of TAUS imaging in the strengthening of a patient's PFMs.

Case Description: The patient was a 29-year-old woman experiencing SUI with high-impact activities following a history of 2 vaginal deliveries, 1 resulting in a grade III perineal laceration. Intervention included PFM training with the use of TAUS imaging. A 1-year follow-up examination was performed to assess the long-term functional outcomes experienced by the patient. The patient's ability to maintain a PFM contraction during motor tasks was documented throughout the course of treatment to demonstrate her gain in PFM control.

Outcomes: The patient gained strength in her PFMs, enabling her to maintain a PFM contraction during various motor tasks. She was able to return to a running program with no SUI symptoms. Her satisfaction level was high at 1 year.

Discussion: The use of TAUS imaging was a helpful assessment and biofeedback tool for re-education and rehabilitation of the PFMs for this patient.

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