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2025 | OriginalPaper | Buchkapitel

36. Ultraschall des Beckenbodens

verfasst von : Prof. Dr. med. Hans-Peter Dietz

Erschienen in: Ultraschalldiagnostik in Geburtshilfe und Gynäkologie

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Dieses Kapitel umreißt den jetzigen Stand der klinischen Forschung auf diesem Gebiet und hebt dabei jene Anwendungen hervor, die für den auf diesem Gebiet praktisch tätigen Gynäkologen und Urologen von besonderem Nutzen sind. Insbesondere werden auch Perspektiven in Bezug auf drittgradige Dammrisse und hinsichtlich von traumatischen Beckenbodenschäden aufgezeigt – nicht nur für die klinische oder bildgebende Diagnose, sondern auch für die Prävention und chirurgische Behandlung dieser Geburtstraumaen.
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Zurück zum Zitat Dietz H, Wilson P (2004) The Iris Effect: how 2D and 3D volume ultrasound can help us understand anti-incontinence procedures. Ultrasound Obstet Gynecol 23:267–271 Dietz H, Wilson P (2004) The Iris Effect: how 2D and 3D volume ultrasound can help us understand anti-incontinence procedures. Ultrasound Obstet Gynecol 23:267–271
Zurück zum Zitat Dietz H, Wilson P (2005) Laparoscopic olposuspension vs. urethropexy: a case control a series. Int Urogynecol J 16:15–18 Dietz H, Wilson P (2005) Laparoscopic olposuspension vs. urethropexy: a case control a series. Int Urogynecol J 16:15–18
Zurück zum Zitat Dietz HP, McKnoulty L, Clarke B (1999) Translabial color Doppler for imaging in urogynecology: a preliminary report. Ultrasound Obstet Gynecol 14:144–147PubMedCrossRef Dietz HP, McKnoulty L, Clarke B (1999) Translabial color Doppler for imaging in urogynecology: a preliminary report. Ultrasound Obstet Gynecol 14:144–147PubMedCrossRef
Zurück zum Zitat Dietz HP, Wilson PD, Clarke B (2001) The use of perineal ultrasound to quantify levator activity and teach pelvic floor muscle exercises. Int Urogynecol J 12:166–168 (discussion 168–169)CrossRef Dietz HP, Wilson PD, Clarke B (2001) The use of perineal ultrasound to quantify levator activity and teach pelvic floor muscle exercises. Int Urogynecol J 12:166–168 (discussion 168–169)CrossRef
Zurück zum Zitat Dietz HP, Clarke B, Vancaillie TG (2002a) Vaginal childbirth and bladder neck mobility. Aust Nz J Obstet Gynaecol 42:522–525CrossRef Dietz HP, Clarke B, Vancaillie TG (2002a) Vaginal childbirth and bladder neck mobility. Aust Nz J Obstet Gynaecol 42:522–525CrossRef
Zurück zum Zitat Dietz HP, Jarvis SK, Vancaillie TG (2002b) The assessment of levator muscle strength: a validation of three ultrasound techniques. Int Urogynecol J 13:156–159CrossRef Dietz HP, Jarvis SK, Vancaillie TG (2002b) The assessment of levator muscle strength: a validation of three ultrasound techniques. Int Urogynecol J 13:156–159CrossRef
Zurück zum Zitat Dietz HP, Eldridge A, Grace M, Clarke B (2004a) Pelvic organ descent in young nulliparous women. Am J Obstet Gynecol 191:95–99PubMedCrossRef Dietz HP, Eldridge A, Grace M, Clarke B (2004a) Pelvic organ descent in young nulliparous women. Am J Obstet Gynecol 191:95–99PubMedCrossRef
Zurück zum Zitat Dietz HP, Foote AJ, Mak HL, Wilson PD (2004b) TVT and Sparc suburethral slings: a case-control series. Int Urogynecol J 15:129–131CrossRef Dietz HP, Foote AJ, Mak HL, Wilson PD (2004b) TVT and Sparc suburethral slings: a case-control series. Int Urogynecol J 15:129–131CrossRef
Zurück zum Zitat Dietz HP, Barry C, Lim YN, Rane A (2005a) Two-dimensional and three-dimensional ultrasound imaging of suburethral slings. Ultrasound Obstet Gynecol 26:175–179PubMedCrossRef Dietz HP, Barry C, Lim YN, Rane A (2005a) Two-dimensional and three-dimensional ultrasound imaging of suburethral slings. Ultrasound Obstet Gynecol 26:175–179PubMedCrossRef
Zurück zum Zitat Dietz HP, Hansell N, Grace M, Eldridge A, Clarke B, Martin N (2005b) Bladder neck mobility is a heritable trait. Br J Obstet Gynaecol 112:334–339CrossRef Dietz HP, Hansell N, Grace M, Eldridge A, Clarke B, Martin N (2005b) Bladder neck mobility is a heritable trait. Br J Obstet Gynaecol 112:334–339CrossRef
Zurück zum Zitat Dietz HP, Shek K, Clarke B (2005c) Biometry of the pubovisceral muscle and levator hiatus by three-dimensional pelvic floor ultrasound. Ultrasound Obstet Gynecol 25:580–585PubMedCrossRef Dietz HP, Shek K, Clarke B (2005c) Biometry of the pubovisceral muscle and levator hiatus by three-dimensional pelvic floor ultrasound. Ultrasound Obstet Gynecol 25:580–585PubMedCrossRef
Zurück zum Zitat Dietz H, Barry C, Lim Y, Rane A (2006) TVT vs Monarc: a comparative study. Int Urogynecol J 17:566–569 Dietz H, Barry C, Lim Y, Rane A (2006) TVT vs Monarc: a comparative study. Int Urogynecol J 17:566–569
Zurück zum Zitat Dietz H, Gillespie A, Phadke P (2007) Avulsion of the pubovisceral muscle associated with large vaginal tear after normal vaginal delivery at term. Aust Nz J Obstet Gynaecol 47:341–344 Dietz H, Gillespie A, Phadke P (2007) Avulsion of the pubovisceral muscle associated with large vaginal tear after normal vaginal delivery at term. Aust Nz J Obstet Gynaecol 47:341–344
Zurück zum Zitat Dietz HP, Abbu A, Shek KL (2008a) The levator urethra gap measurement: an objective means of determining levator avulsion? Ultrasound Obstet Gynecol 32:941–945PubMedCrossRef Dietz HP, Abbu A, Shek KL (2008a) The levator urethra gap measurement: an objective means of determining levator avulsion? Ultrasound Obstet Gynecol 32:941–945PubMedCrossRef
Zurück zum Zitat Dietz HP, De Leon J, Shek K (2008b) Ballooning of the levator hiatus. Ultrasound Obstet Gynecol 31:676–680PubMedCrossRef Dietz HP, De Leon J, Shek K (2008b) Ballooning of the levator hiatus. Ultrasound Obstet Gynecol 31:676–680PubMedCrossRef
Zurück zum Zitat Dietz HP, Kirby A, Shek K, Bedwell P (2009) Does avulsion of the puborectalis muscle affect bladder function? Int Urogynecol J 20:967–972CrossRef Dietz HP, Kirby A, Shek K, Bedwell P (2009) Does avulsion of the puborectalis muscle affect bladder function? Int Urogynecol J 20:967–972CrossRef
Zurück zum Zitat Dietz HP, Chantarasorn V, Shek KL (2010) Levator avulsion is a risk factor for cystocele recurrence. Ultrasound Obstet Gynecol 36:76–80PubMedCrossRef Dietz HP, Chantarasorn V, Shek KL (2010) Levator avulsion is a risk factor for cystocele recurrence. Ultrasound Obstet Gynecol 36:76–80PubMedCrossRef
Zurück zum Zitat Dietz HP, Bernardo MJ, Kirby A, Shek KL (2011a) Minimal criteria for the diagnosis of avulsion of the puborectalis muscle by tomographic ultrasound. Int Urogynecol J 22:699–705PubMedCrossRef Dietz HP, Bernardo MJ, Kirby A, Shek KL (2011a) Minimal criteria for the diagnosis of avulsion of the puborectalis muscle by tomographic ultrasound. Int Urogynecol J 22:699–705PubMedCrossRef
Zurück zum Zitat Dietz HP, Erdmann M, Shek K (2011b) Mesh contraction: myth or reality? Am J Obstet Gynecol 204:173.e1–173.e4PubMedCrossRef Dietz HP, Erdmann M, Shek K (2011b) Mesh contraction: myth or reality? Am J Obstet Gynecol 204:173.e1–173.e4PubMedCrossRef
Zurück zum Zitat Dietz HP, Shek K, Chantarasorn V, Langer S (2011c) Do women notice the effect of childbirth-related pelvic floor trauma? Int Urogynecol J 22:6667 Dietz HP, Shek K, Chantarasorn V, Langer S (2011c) Do women notice the effect of childbirth-related pelvic floor trauma? Int Urogynecol J 22:6667
Zurück zum Zitat Dietz HP, Bond V, Shek KL (2012a) Does childbirth alter the reflex pelvic floor response to coughing? Ultrasound Obstet Gynecol 39:569–573PubMedCrossRef Dietz HP, Bond V, Shek KL (2012a) Does childbirth alter the reflex pelvic floor response to coughing? Ultrasound Obstet Gynecol 39:569–573PubMedCrossRef
Zurück zum Zitat Dietz HP, Korda A, Benness C, Wong V, Shek KL, Daly O (2012b) Surgical reduction of the levator hiatus. Neurourol Urodyn 31:872–873 Dietz HP, Korda A, Benness C, Wong V, Shek KL, Daly O (2012b) Surgical reduction of the levator hiatus. Neurourol Urodyn 31:872–873
Zurück zum Zitat Dietz HP, Velez D, Shek KL, Martin A (2012c) Determination of postvoid residual by translabial ultrasound. Int Urogynecol J 23:1749–1752PubMedCrossRef Dietz HP, Velez D, Shek KL, Martin A (2012c) Determination of postvoid residual by translabial ultrasound. Int Urogynecol J 23:1749–1752PubMedCrossRef
Zurück zum Zitat Dietz HP, Nazemian K, Shek KL, Martin A (2013a) Can urodynamic stress incontinence be diagnosed by ultrasound? Int Urogynecol J 24:1399–1403PubMedCrossRef Dietz HP, Nazemian K, Shek KL, Martin A (2013a) Can urodynamic stress incontinence be diagnosed by ultrasound? Int Urogynecol J 24:1399–1403PubMedCrossRef
Zurück zum Zitat Dietz HP, Shek KL, Daly O, Korda A (2013b) Can levator avulsion be repaired surgically? Int Urogynecol J 24:1011–1015PubMedCrossRef Dietz HP, Shek KL, Daly O, Korda A (2013b) Can levator avulsion be repaired surgically? Int Urogynecol J 24:1011–1015PubMedCrossRef
Zurück zum Zitat Dietz HP, Caudwell-Hall J, Shek KL, Langer SE (2014) The effect of replacing primary vacuum delivery with forceps. Ultrasound Obstet Gynecol 44(S1):95CrossRef Dietz HP, Caudwell-Hall J, Shek KL, Langer SE (2014) The effect of replacing primary vacuum delivery with forceps. Ultrasound Obstet Gynecol 44(S1):95CrossRef
Zurück zum Zitat Dietz HP, Pardey J, Murray HG (2015) Maternal birth trauma should be a key performance indicator of maternity services. Int Urogynecol J 26:29–32PubMedCrossRef Dietz HP, Pardey J, Murray HG (2015) Maternal birth trauma should be a key performance indicator of maternity services. Int Urogynecol J 26:29–32PubMedCrossRef
Zurück zum Zitat Dietz HP, Kamisan Atan I, Salita A (2016) The association between ICS POPQ coordinates and translabial ultrasound findings. Ultrasound Obstet Gynecol 47:363–368PubMedCrossRef Dietz HP, Kamisan Atan I, Salita A (2016) The association between ICS POPQ coordinates and translabial ultrasound findings. Ultrasound Obstet Gynecol 47:363–368PubMedCrossRef
Zurück zum Zitat Dietz HP, Pattillo Garnham A, Guzmán Rojas R (2017) Diagnosis of levator avulsion: Is it necessary to perform TUI on pelvic floor muscle contraction? Ultrasound Obstet Gynecol 49:252–256PubMedCrossRef Dietz HP, Pattillo Garnham A, Guzmán Rojas R (2017) Diagnosis of levator avulsion: Is it necessary to perform TUI on pelvic floor muscle contraction? Ultrasound Obstet Gynecol 49:252–256PubMedCrossRef
Zurück zum Zitat Dietz HP, Stankiewicz M, Kamisan Atan I, Ferreira CWS, Socha M (2018) Vaginal Laxity: What does this symptom mean? Int Urogynecol J 29:723–728PubMedCrossRef Dietz HP, Stankiewicz M, Kamisan Atan I, Ferreira CWS, Socha M (2018) Vaginal Laxity: What does this symptom mean? Int Urogynecol J 29:723–728PubMedCrossRef
Zurück zum Zitat Dietz HP, Korda A, Pardey J, Shek KL, Wong V, Caudwell Hall J, Langer S, Benness C (2020) Hiatal reduction with the ’Puborectalis Sling’: a multicentre randomised controlled trial. Int Urogynecol J 54:S3–S4 Dietz HP, Korda A, Pardey J, Shek KL, Wong V, Caudwell Hall J, Langer S, Benness C (2020) Hiatal reduction with the ’Puborectalis Sling’: a multicentre randomised controlled trial. Int Urogynecol J 54:S3–S4
Zurück zum Zitat Dietz HP, Shek KL, Low GK (2022a) Validation of new ultrasound algorithm for estimating prevalence of anal sphincter trauma in a urogynecological population. Ultrasound Obstet Gynecol 60:800–804PubMedCrossRef Dietz HP, Shek KL, Low GK (2022a) Validation of new ultrasound algorithm for estimating prevalence of anal sphincter trauma in a urogynecological population. Ultrasound Obstet Gynecol 60:800–804PubMedCrossRef
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Zurück zum Zitat Shek KL, Dietz HP (2015) What is ‘abnormal uterine descent’ on translabial ultrasound? Int Urogyn J 26:1783–1787CrossRef Shek KL, Dietz HP (2015) What is ‘abnormal uterine descent’ on translabial ultrasound? Int Urogyn J 26:1783–1787CrossRef
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Zurück zum Zitat Shek K, Dietz HP, Rane A, Balakrishnan S (2008) Transobturator mesh for cystocele repair: a short- to medium term follow-up using 3D/4D ultrasound. Ultrasound Obstet Gynecol 32:82–86PubMedCrossRef Shek K, Dietz HP, Rane A, Balakrishnan S (2008) Transobturator mesh for cystocele repair: a short- to medium term follow-up using 3D/4D ultrasound. Ultrasound Obstet Gynecol 32:82–86PubMedCrossRef
Zurück zum Zitat Shek K, Chantarasorn V, Dietz H (2010a) Can levator avulsion be predicted antenatally? Am J Obstet Gynecol 202:586.e1–586.e6PubMedCrossRef Shek K, Chantarasorn V, Dietz H (2010a) Can levator avulsion be predicted antenatally? Am J Obstet Gynecol 202:586.e1–586.e6PubMedCrossRef
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Zurück zum Zitat Shek KL, Chantarasorn V, Langer S, Dietz HP (2012a) Does levator trauma heal? Ultrasound Obstet Gynecol 40:570–575PubMedCrossRef Shek KL, Chantarasorn V, Langer S, Dietz HP (2012a) Does levator trauma heal? Ultrasound Obstet Gynecol 40:570–575PubMedCrossRef
Zurück zum Zitat Shek KL, Kruger J, Dietz HP (2012b) The effect of pregnancy on hiatal dimensions and urethral mobility: a case control study. Int Urogynecol J 23:1561–1567PubMedCrossRef Shek KL, Kruger J, Dietz HP (2012b) The effect of pregnancy on hiatal dimensions and urethral mobility: a case control study. Int Urogynecol J 23:1561–1567PubMedCrossRef
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Zurück zum Zitat Shek KL, Guzman Rojas R, Dietz HP (2014) Residual defects of the external anal sphincter following primary repair: an observational study using transperineal ultrasound. Ultrasound Obstet Gynecol 44:704–709PubMedCrossRef Shek KL, Guzman Rojas R, Dietz HP (2014) Residual defects of the external anal sphincter following primary repair: an observational study using transperineal ultrasound. Ultrasound Obstet Gynecol 44:704–709PubMedCrossRef
Zurück zum Zitat Shek KL, Green K, Caudwell Hall J, Guzman Rojas R, Dietz HP (2016a) Perineal and vaginal tears are clinical markers for occult levator ani trauma: a retrospective observational study. Ultrasound Obstet Gynecol 47:224–227PubMedCrossRef Shek KL, Green K, Caudwell Hall J, Guzman Rojas R, Dietz HP (2016a) Perineal and vaginal tears are clinical markers for occult levator ani trauma: a retrospective observational study. Ultrasound Obstet Gynecol 47:224–227PubMedCrossRef
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Zurück zum Zitat Siafarikas F, Staer-Jensen J, Braekken I, Bø K, Engh M (2013) Learning process for performing and analyzing 3D/4D transperineal ultrasound imaging and interobserver reliability study. Ultrasound Obstet Gynecol 41:312–317PubMedCrossRef Siafarikas F, Staer-Jensen J, Braekken I, Bø K, Engh M (2013) Learning process for performing and analyzing 3D/4D transperineal ultrasound imaging and interobserver reliability study. Ultrasound Obstet Gynecol 41:312–317PubMedCrossRef
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Zurück zum Zitat Steensma AB, Oom DMJ, Burger CW, Schouten WR (2007) Comparison of defecography and 3D/4D translabial ultrasoundin patients with pelvic organ prolapse and/ or evacuation disorders. Ultrasound Obstet Gynecol 30:447CrossRef Steensma AB, Oom DMJ, Burger CW, Schouten WR (2007) Comparison of defecography and 3D/4D translabial ultrasoundin patients with pelvic organ prolapse and/ or evacuation disorders. Ultrasound Obstet Gynecol 30:447CrossRef
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Zurück zum Zitat Wong N, Cheung R, Lee L, Wan K, Choy K, Chan S (2021) Women with advanced pelvic organ prolapse and levator ani muscle avulsion would significantly benefit from mesh repair surgery. Ultrasound Obstet Gynecol 57:631–638PubMedCrossRef Wong N, Cheung R, Lee L, Wan K, Choy K, Chan S (2021) Women with advanced pelvic organ prolapse and levator ani muscle avulsion would significantly benefit from mesh repair surgery. Ultrasound Obstet Gynecol 57:631–638PubMedCrossRef
Zurück zum Zitat Wong V, Shek K, Goh J, Rane A, Dietz H (2011) Should mesh be used for cystocele repair? Long-term outcomes of a case-control series. Int Urogynecol J 22:91 Wong V, Shek K, Goh J, Rane A, Dietz H (2011) Should mesh be used for cystocele repair? Long-term outcomes of a case-control series. Int Urogynecol J 22:91
Zurück zum Zitat Wong V, Shek KL, Rane A, Goh J, Krause H, Dietz HP (2013) Is levator avulsion a predictor of recurrence after anterior compartment mesh? Ultrasound Obstet Gynecol 42:230–234PubMedCrossRef Wong V, Shek KL, Rane A, Goh J, Krause H, Dietz HP (2013) Is levator avulsion a predictor of recurrence after anterior compartment mesh? Ultrasound Obstet Gynecol 42:230–234PubMedCrossRef
Zurück zum Zitat Wong V, Guzman Rojas R, Shek KL, Chou D, Moore K, Dietz HP (2017) Laparoscopic sacrocolpopexy: how low does the mesh go? Ultrasound Obstet Gynaecol 49:404–408CrossRef Wong V, Guzman Rojas R, Shek KL, Chou D, Moore K, Dietz HP (2017) Laparoscopic sacrocolpopexy: how low does the mesh go? Ultrasound Obstet Gynaecol 49:404–408CrossRef
Zurück zum Zitat Yagel S, Valsky DV (2006) Three-dimensional transperineal sonography for evaluation of the anal sphincter complex: another dimension in understanding peripartum sphincter trauma. Ultrasound Obstet Gynecol 27:119–123PubMedCrossRef Yagel S, Valsky DV (2006) Three-dimensional transperineal sonography for evaluation of the anal sphincter complex: another dimension in understanding peripartum sphincter trauma. Ultrasound Obstet Gynecol 27:119–123PubMedCrossRef
Zurück zum Zitat Yan Y, Dou C, Wang X, Xi Y, Hu B, Ma L, Ying T (2017) Combination of tomographic ultrasound imaging and three-dimensional magnetic resonance imaging-based model to diagnose postpartum levator avulsion. Sci Rep 7:11235PubMedPubMedCentralCrossRef Yan Y, Dou C, Wang X, Xi Y, Hu B, Ma L, Ying T (2017) Combination of tomographic ultrasound imaging and three-dimensional magnetic resonance imaging-based model to diagnose postpartum levator avulsion. Sci Rep 7:11235PubMedPubMedCentralCrossRef
Zurück zum Zitat Yang J, Yang S, Huang W (2006) Biometry of the pubovisceral muscle and levator hiatus in nulliparous Chinese women. Ultrasound Obstet Gynecol 26:710–716CrossRef Yang J, Yang S, Huang W (2006) Biometry of the pubovisceral muscle and levator hiatus in nulliparous Chinese women. Ultrasound Obstet Gynecol 26:710–716CrossRef
Zurück zum Zitat Young N, Atan I, Rojas R, Dietz HP (2018) Obesity: how much does it matter for female pelvic organ prolapse? Int Urogynecol J 29:1129–1134PubMedCrossRef Young N, Atan I, Rojas R, Dietz HP (2018) Obesity: how much does it matter for female pelvic organ prolapse? Int Urogynecol J 29:1129–1134PubMedCrossRef
Zurück zum Zitat Youssef A, Salsi G, Cataneo I, Pacella G, Azzarone C, Paganotto M, Krsmanovic J, Montaguti E, Cariello L, Bellussi F, Rizzo N, Pilu G (2019) Fundal pressure in second stage of labor (Kristeller maneuver) is associated with increased risk of levator ani muscle avulsion. Ultrasound Obstet Gynecol 53:95–100PubMedCrossRef Youssef A, Salsi G, Cataneo I, Pacella G, Azzarone C, Paganotto M, Krsmanovic J, Montaguti E, Cariello L, Bellussi F, Rizzo N, Pilu G (2019) Fundal pressure in second stage of labor (Kristeller maneuver) is associated with increased risk of levator ani muscle avulsion. Ultrasound Obstet Gynecol 53:95–100PubMedCrossRef
Zurück zum Zitat Zazzera DV, Kamisan Atan I, Guzman Rojas R, Langer S, Dietz HP (2015) Does anal sphincter trauma heal? Int Urogynecol J 26(S1):S68–S69 Zazzera DV, Kamisan Atan I, Guzman Rojas R, Langer S, Dietz HP (2015) Does anal sphincter trauma heal? Int Urogynecol J 26(S1):S68–S69
Zurück zum Zitat Zbar A, Beer-Gabel M (2008) Dynamic transperineal ultrasonography. In: Pescatori M, Regadas F, Regadas MS, Zbar A (Hrsg) Imaging atlas of the pelvic floor and anorectal diseases. Springer: S. 189–196CrossRef Zbar A, Beer-Gabel M (2008) Dynamic transperineal ultrasonography. In: Pescatori M, Regadas F, Regadas MS, Zbar A (Hrsg) Imaging atlas of the pelvic floor and anorectal diseases. Springer: S. 189–196CrossRef
Zurück zum Zitat Zhang X, Shek KL, Dietz HP (2015) How large does a rectocele have to be to cause symptoms? Int Urogynecol J 26:1355–1359PubMedCrossRef Zhang X, Shek KL, Dietz HP (2015) How large does a rectocele have to be to cause symptoms? Int Urogynecol J 26:1355–1359PubMedCrossRef
Zurück zum Zitat Zhuang R, Song Y, Chen Q, Ma M, Huang H, Chen J, Li Y (2011) Levator avulsion using a tomographic ultrasound and magnetic resonance-based model. Am J Obstet Gynecol 205:232.e1–232.e8PubMedCrossRef Zhuang R, Song Y, Chen Q, Ma M, Huang H, Chen J, Li Y (2011) Levator avulsion using a tomographic ultrasound and magnetic resonance-based model. Am J Obstet Gynecol 205:232.e1–232.e8PubMedCrossRef
Metadaten
Titel
Ultraschall des Beckenbodens
verfasst von
Prof. Dr. med. Hans-Peter Dietz
Copyright-Jahr
2025
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-67373-7_36