I am a bit of a gadget geek, and this awesome machine is definitely top of my list! I’ve been using my ultrasound machine in clinic for a year now and it’s a fantastic tool to have. I’m using it more and more to help gain more information during an assessment and as a biofeedback tool to teach/educate patients on what’s happening in their abdominal wall and/or pelvic floor.
I use the ultrasound in two ways: transabdominal and transperineal/translabial
1. Transabdominal
Using ultrasound to check out what the abdominal wall is doing is just next level! I am using this now in most post natal check ups to assess the abdominal wall for “tummy separation” (I don’t like this term anymore…you tummy is not separated, rather it might need a wee hand to function a bit better and strengthen) and for any patients to check their “core function”. I can see how you are breathing, what your core muscles are doing and if you can switch them on.
I can also assess the pelvic floor here by having the probe just above the pubic bone and getting a good view of a full-ish bladder. By finding the base of the bladder and asking for a pelvic floor contraction, I can see if the bladder base lifts up, relaxes, bears down indicating how the pelvic floor muscles are working. This is a great alternative to a vaginal examination to assess the pelvic floor, but when used in conjunction with a vaginal exam gives me a ton of information to make a more definitive diagnosis. I can also teach you how your pelvic floor contracts and relaxes – seeing the movement is a great way to learn to connect to your pelvic floor. This is also how I assess children’s pelvic floor’s and measure rectal width when looking for constipation.
2. Transperineal/translabial
The probe is placed on the perineum (the area between the back of the vagina and the anus) and/or between the labia. Very little pressure is needed to get a great view of the bladder, uterus, vagina and rectum. In this position it’s possible to check for how the bladder responds to coughing/sneezing/bearing down (like you are trying to poo) to help decide the best course of treatment for stress urinary incontinence. You can also see the pull forward of the pelvic floor, how well it relaxes and again to teach you how to exercise the pelvic floor. It’s a great way for patients who have any pelvic pain to have their pelvic floor assessed in a pain free way.
I’m not a radiographer – they are the highly skilled technicians who work in the radiology clinics and make sense of these black and white images on the screen. I’m not using the ultrasound to diagnose anything – this is not it’s purpose in my clinic. But looking at how muscles function, and being able to show patients how their muscles work has been invaluable in my physio treatment. And having an alternative to internal vaginal exams is just another bonus!