Learning curve and applicability of 3D/4D translabial ultrasound for
diagnosing levator ani defects

Levatordefects occur in approximately 20-30% of deliveries. Levatordefects are
a risk factor for developing pelvic floor dysfunction and prolapse.
Levatordefects are associated with an increased risk for recurrence after
surgery. Levatordefects can be diagnosed by 3D/4D translabial ultrasound and by
MR imaging. The role of ultrasound in daily care for diagnosing levatordefects
in relation to the reference standard MRI has to be assessed. For this
assessment and for clinical practice we have to know whether it is necessary
that the gynecologists performs and reads the ultrasound scans or someone else
can learn to make thes scans and judge them.This study focuses on the learning
curve of 3D translabial 3D ultrasound of the pelvic floor to prepare the
implementation of pelvic floor ultrasound. All studies described in literature
are performed on the Voluson GE Kretz . We need to know whether the knowledge
of the software applications for optimizing the images on the Voluson
ultrasound machine can be extrapolated to other machines.

The first aim is to study the learning curve of a student and a gynecologist
for performing a translabial 3D ultrasound scan and of the capacity to read a
scan and judge the integrity of the levator ani. Furthermore a comparison will
be made between two ultrasound machines to find out whether the knowledge of
the Voluson GE Kretz on translabial ultrasound of the pelvic floor can be
extrapolated to other machines.

multicentre prospective observational cohort study

Patients that join the study have to visit the hospital one time extra.
Ultrasonography of the levator ani has no risk for general health and no
radiation is used. The ultrasound exam will be performed by three different
docters. No questionnaires and no follow-up appointment are needed.
There is no benefit for the patient by joining the study.
The costs for travelling and parking will be compensated.