Levator Ani

[Diane]

Hi Steve,
We had a referral the other day where the GP requested to look at the levator ani. When I was scanning the patient, the pain seemed to be more at the adductors origin.
My work colleague said he went to a conference and they said the levator ani is a male pelvic floor thing.

Are we able to look at the levator ani easily or is this more a specialist thing?

Thanks!

[Stephen Bird]

Hi Diane,

In my experience it is a female “pelvic floor thing” as you put it,

The elevator ani is a collection of small individual muscles which make up the pelvic floor and provide support for the urethra, vagina and rectum. It may be damages during childbirth and this is when we are asked to examine the pelvic floor for assessment of cystooceles, cystourethroceles, enteroceles and rectoceles.

I use a tread perineal technique with a 3D volume acquiring convex array transducer.

I can assess for the different types of pathology using 2D scanning only, but to ascertain the integrity of the puborectalis muscle (part of the elevator ani group) which borders the lateral margin of the vagina I need to do a volume and reconstruct in the C-plane.

The images are really nice and you can measure the hiatus of the elevator ani during rest and straining.

If you would like to read more on pelvic floor I have many resources I can share with you.

I have never been asked to examine this in a male patient so that I can not help you with,

If anyone else knows about male elevator ani assessment please share your thoughts and experience on this thread.

Steve

[Author]

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