Ultrasound of the pelvic organs for adults and children: what are the differences, what is checked and identified, how to prepare and much more

Features of the anatomy of the genital organs in women

The female reproductive system performs several functions, one way or another related to procreation. The anatomy of this system includes the internal and external genitalia. The internal genital organs are located in the pelvic cavity. These include:

The vagina is an elastic tube 10–12 cm long with walls 3–4 mm thick. This is the channel for the exit of the fetus during childbirth and the receiver of male seed during sexual intercourse.
The uterus is the reproductive organ where the embryo is born. Located behind the bladder. It is distinguished by powerful muscle tissues that can expand during pregnancy.
Fallopian tubes located on both sides of the uterus. Their function is to move the fertilized egg into the uterus.
The ovaries are paired glands located in the abdominal cavity below the level of the navel. Responsible for the maturation of eggs.

External organs of the female reproductive system:

The pubis is a soft tissue formation above the labia.
Labia. They are divided into large and small. Protect the vagina and maintain thermal conditions.
The clitoris is an erogenous zone with high sensitivity. Responsible for sexual arousal.

The pelvic muscles in women are conventionally divided into three layers, differing in location. The deepest is divided into the pubic, ischial and iliac parts. All parts are attached to the pubic symphysis and pubic bone.

CT scan of the pelvic organs in a good clinic

In our clinic, CT scans of the pelvis can be performed in comfortable conditions. The center’s doctors are highly qualified and know how to properly carry out this procedure. After the examination, patients are given a conclusion and can receive advice from an experienced specialist. The clinic has modern equipment for high-quality pelvic diagnostics. Doctors use effective methods for identifying pathologies at the stage of their inception.

Modern equipment for examining the pelvis allows you to perform up to 128 sections. The accuracy of diagnosis depends on the number of sections; the more, the better. Scanning an area of 5 cm takes approximately 5 seconds. The accuracy of the results is beyond doubt.

There are tomographs that allow you to examine organs in the pelvis in women and men not only with normal weight, but also with excess weight. In some cases, the procedure is performed with contrast. The use of a contrast agent, usually iodine, improves the quality of the resulting images. This greatly simplifies making the correct diagnosis.

Many people are interested in what a pelvic CT scan shows in male and female patients. With the help of such diagnostics, various pathologies are identified.

Weakness of the pelvic floor muscles: problems and consequences

If your pelvic floor muscles are weak, you are at risk for the following problems:

anorgasmia (loss of sensation and inability to experience sexual pleasure);
urinary incontinence while walking, coughing, playing sports;
prolapse and prolapse of the uterus outside the vagina;
severe abdominal pain.

20% of women aged 21–29 years and 55% of women aged 30 to 40 experience certain symptoms associated with weakening of the pelvic muscles. In the age group over 45 years old, muscle weakness occurs in 75% of cases. If you ignore the problem, the condition progresses, causing complications.

Indications for computed tomography of organs located in the pelvis

CT allows you to examine the rectum, bladder and ureters, prostate gland in representatives of the stronger sex, as well as the uterus and vagina in women.

It is recommended to undergo such an examination if:

pain in the pelvis and sacrum;
injuries of bones and soft tissues;
suspected pathology of the rectum;
congenital disorders in the structure of the genitourinary system.

Another reason for undergoing such a diagnosis is infertility.

For men, CT scans are prescribed to diagnose benign and malignant tumors in the prostate area, prostatitis. In the fairer sex, endometriosis is detected using computed tomography. Women often undergo a CT scan if there is a suspicion of rupture of an ovarian cyst or capsule. Moreover, diagnostics in such cases is carried out on an emergency basis. A tomography examination is also indicated for vaginal bleeding, the cause of which is unclear.

Indications for training

Training for pelvic floor muscle dysfunction is prescribed by a doctor after eliminating contraindications. Considering the structure of the organs located in the female pelvis, symptoms of muscle weakness can be determined independently. Indications for starting intimate ligament training are factors such as:

Childbirth planning. Due to the strengthened muscular corset, the uterus will receive the necessary support, and the risk of prolapse or prolapse of the organ will be reduced.
The period during pregnancy and after childbirth. Due to trained muscles, the birth process is accelerated and facilitated, and the risk of perineal ruptures is reduced. After childbirth, the genitals will quickly recover to their previous state.
Age over 30 years. Most women have weakened pelvic floor muscles with age if they are not trained. To avoid problems in the future, even in the absence of unpleasant symptoms, gymnastics of the intimate muscles is indicated.
Injuries and surgeries in the female pelvic floor. In this case, the natural contraction of muscles is disrupted, and with it the transmission of nerve impulses. As a result, incontinence, anorgasmia and other problems develop.
Hormonal disbalance. Poor blood circulation due to metabolic disorders leads to thinning of the vaginal walls and a decrease in its elasticity.
Physical inactivity. A sedentary lifestyle leads to loss of elasticity and muscle tone. They contract worse, which affects the functioning of all pelvic organs.

Why is a pelvic CT scan prescribed?

Diseases of organs located in the pelvis are common. The earlier the pathology is detected, the greater the chances of successful treatment. To diagnose disorders they perform. This procedure can be prescribed to patients of both sexes.

It is carried out in order to detect:

benign and malignant tumors;
injuries and violations of bone integrity;
ruptures of internal organs;
negative transformations in veins and vessels.

This examination is prescribed if there is a suspicion of prolapse or prolapse of the bladder. It makes it possible to detect sand with stones in the bladder and ureters.

For women, CT scans are prescribed to identify inflammatory pathologies, prolapse or prolapse of the uterus. It allows you to find out if there is an accumulation of blood with pus in the lumen of the fallopian tube.

In men, tomography can reveal:

prostatitis;
prostate adenoma;
inflammatory processes in the seminal vesicles;
disorders in the development of the genitourinary system;
inflammation of the testicles.

While studying the images, the doctor assesses the condition of the tailbone and other tissues. This method of examination makes it possible to differentiate pathologies, since diagnosis in many cases is complicated by similar symptoms.

Due to a detailed examination, the diagnosis is greatly simplified.

Contraindications to strengthening the pelvic muscles

Physical exercise has contraindications, so you must first consult a gynecologist or other specialized specialist so as not to harm your health. You should not do exercises for the perineum in the following cases:

damage to the mucous membranes of the vagina and uterus;
chronic diseases at the time of exacerbation (cystitis, endometritis);
recent surgeries on the pelvic organs;
the presence of neoplasms of any type;
erosion of the uterine wall;
pathologies of the heart and blood vessels.

Other contraindications relate to increased uterine tone, the risk of miscarriage and premature birth.

Violation of the symmetry of the pelvic bones and its joints

The pelvis (pelvic bones, sacrum) is the place where all ascending (from the legs) and descending (from the head, from the spine, from the upper limbs) motor processes converge. In other words, the pelvis is the central transmission link in the distribution of movement between the upper and lower parts of the body. Many diseases affecting the spine, joints of the arms and legs depend on the pelvis. Violation of the symmetry of the pelvic bones and its joints is the main cause of pain syndromes.

What is the pelvis?

The pelvis is a set of pelvic bones (iliac, ischial, pubic) that articulate with each other, the sacrum and the coccyx to form joints. These bones have a certain mobility, which means that in addition to their normal, physiological state, they can, when displaced, acquire pathological mobility.

Diseases of this part of the musculoskeletal system can affect different structures. These are joints, for example, the sacroiliac joint, which often gives acute pain - SACRIOLIITIS, SACRIOLIAC RADICULITIS. It is also the joint between the last lumbar vertebra and the sacrum, where, in addition to the displacement of these bones, there may be a pathology of the intervertebral disc - DISC HERNIA or protrusion, which leads to very painful and painful manifestations. The sacrococcygeal joint may suffer, especially with displacement of the coccyx and ligament diseases in this area. The symphysis pubis often suffers (complete or partial ruptures) - with sports injuries, during childbirth in women; hip joints. As a result, pain appears in this area.

But the pelvis is not only bones; chiropractors and osteopaths often note in their practice pain syndromes coming from numerous ligaments of the pelvis and its muscles. Sometimes the pain from the ligaments is so acute that the patient, exhausted by this suffering, cannot even get to the doctor. This is a whole drama for him. Pain from displacement of the sacrum can irritate the nerve roots and then neurologists and chiropractors see manifestations of SACRIOLIAC RADICULOPATHY, when the patient suffers from pain not only in the pelvic area, but also in the leg. In addition, numbness in the legs, weakness, and inability to stand and move appear. I don’t think that everything that has been said needs to be explained how much these manifestations complicate the patient’s life.

In addition to the above, diseases of the pelvic area can often be caused by the pelvic muscles - these are the piriformis, the obturator muscles of the pelvis. They, in turn, can cause or aggravate DISEASES OF THE HIP JOINTS. Let's not forget that due to pathology of the lumbosacral and pelvic regions, the pelvic organs - the genitourinary (female, male) and intestines - can suffer.

Also, which is very important, if the symmetry of the pelvis is disturbed, SCOLIOSIS and POSTURAL DISORDERS can develop, and these diseases cause a whole complex of pain syndromes.

Treatment of numerous pathologies of the pelvic area and lumbosacral region should always be prescribed taking into account the localization of the process, the cause of the disease, the anatomy of this area, age, gender, and the nature of the load. In each individual case it is individual. The main thing is to see a doctor in time, accurately establish a diagnosis, and prescribe treatment. Specialists at the First Family Clinic of St. Petersburg are confident that patients with these diseases can be helped and their suffering alleviated. We will be happy to help you regain your health and joy of life!

Neurologist, chiropractor Trofimov Maxim Valerievich.

Publications in the media

An anatomically narrow pelvis is a pelvis in which at least one dimension is shortened by 1.5–2 cm compared to normal. A functionally narrow pelvis (clinically narrow pelvis) is a pelvis that impedes the course of labor due to the disproportion between the fetal head and the woman’s pelvis. Etiology: infantilism, delayed development of the body, rickets, tuberculosis of bones and joints, fractures of the pelvic bones, deformities of the pelvis, spine, lower extremities, acceleration, etc. Classification According to structural features • Gynecoid pelvis - a normal pelvis of the female type •• Android pelvis - a female pelvis of a male or funnel-shaped type •• Anthropoid pelvis - a pelvis with an elongated anteroposterior size and a shortened transverse diameter •• Platypeloid pelvis - a flat, narrow pelvis. According to the shape of the narrowing • Generally uniformly narrowed pelvis - all dimensions are reduced by the same amount, usually by 1.5–2 cm • Transversely narrowed pelvis - reduction in transverse dimensions with a normal (or increased) size of the true conjugate • Flat pelvis - shortening of direct dimensions with a normal value of transverse and oblique sizes •• Simple flat pelvis - all direct dimensions are shortened •• Flat scorachitic pelvis - shortening only the direct size of the inlet (true conjugate). Signs: change in the shape of the sacrum and other pelvic bones, a decrease in the true conjugate, a kidney-shaped shape of the entrance to the pelvis, the size of the entrance to the pelvis is smaller than the size of the exit • Generally narrowed flat pelvis - a decrease in all sizes, but the straight lines are shortened more than all others • An oblique (asymmetrical) pelvis occurs after history of rickets, dislocation of the hip joint, scoliosis. The cause is depression of the acetabulum on one side • Lordotic pelvis is observed with lordosis in the lumbosacral region; the direct size of the inlet to the pelvis is reduced, the pelvis is anatomically narrow • Funnel-shaped pelvis is a pelvis in which the inlet dimensions are normal, and the outlet dimensions are narrowed in the transverse or transverse and anteroposterior directions. The sacrum is elongated, the pubic arch is narrow • Kyphotic pelvis - kyphosis of the spine causes deformation of the pelvis: an increase in the true conjugate, a decrease in the transverse size of the pelvic outlet, the pubic angle is acute, the pelvic cavity is funnel-shaped • Spondylolistic pelvis - an anatomically narrow pelvis with a reduced direct size of the inlet due to slipping of the fifth lumbar vertebra from the base of the sacrum • Osteomalactic pelvis - a pelvis deformed as a result of osteomalacia; pressure from internal organs on the pelvis and lateral pressure from the heads of the femurs lead to deformation of the pelvic aperture; the aperture is either triangular or shaped like a stylized heart, while the pubis takes on a beak-like shape • Pelvis narrowed by exostoses and bone tumors. By degree of narrowing •• I degree. The true conjugate is 9–11 cm. In most cases, childbirth occurs without complications •• II degree. The true conjugate is 7.5–9 cm. Natural delivery is possible, but complications often occur •• III degree. The true conjugate is 6.5–7.5 cm. Delivery of a full-term fetus through natural means is impossible. For vaginal delivery, fetal destruction surgery is indicated •• IV degree. The true conjugate is less than 6.5 cm. Vaginal delivery is impossible even with the use of fetal destruction surgery. Diagnostics • History: infantilism, past illnesses and injuries, obstetric history • Objective examination: general examination, height 150 cm and below, assessment of Michaelis rhombus, spinal curvature, joint mobility; a saggy belly in multiparous women and a pointed belly in primiparous women. In addition to the generally accepted external pelviometry, it is necessary to measure the distance between the anterosuperior and posterosuperior spines of one side (14–15 cm), and the height of the symphysis pubis (4–5 cm). To clarify the thickness of the bones, the circumference of the wrist joint is measured - the Solovyov index (14–15 cm). Vaginal examination: relief of the inner surface of the pelvis, true conjugate. The course of pregnancy • Due to the high position of the uterine fundus, pregnant women complain of shortness of breath, palpitations, fatigue • In the second half of pregnancy, gestosis often occurs • Premature discharge of amniotic fluid often occurs, because the fetal head is mobile, therefore, the amniotic fluid is not divided into anterior and posterior. Incorrect position of the fetus and breech presentation are often observed. The course of labor . With I and II degrees of pelvic narrowing, the course of labor depends on many factors, for example, on the size of the fetal head, intensity of labor, fetal presentation, etc. With III and IV degrees of pelvic narrowing, a cesarean section is indicated. Complications during childbirth • Early rupture of amniotic fluid with prolapse of the umbilical cord loop or fetal arm • Abnormalities of labor • Asynclitic insertion, extensor presentation of the head • Overdistension of the lower segment of the uterus and uterine rupture • Compression of the soft tissues of the birth canal between the pelvic bones and the fetal head with the formation of necrosis and fistulas • Impaired uteroplacental circulation • Bleeding in the placenta and postpartum periods • Complications from the fetus: fetal hypoxia, cerebral hemorrhage, cephalohematoma, depressions and cracks of the skull bones, fractures of the clavicle and limbs • Death of the mother and fetus.

Mechanism of birth • Generally uniformly narrowed pelvis •• Maximum flexion of the head, the small fontanelle is located on the center line of the pelvis •• The sagittal suture of the fetal head corresponds to the oblique size of the entrance to the pelvis, accordingly, the large transverse size of the head also passes through the oblique size •• The area of the suboccipital fossa cannot approach symphysis, so the head moves toward the perineum at birth, and deep ruptures often occur. • Transversely narrowed pelvis. When the sagittal suture corresponds to the direct size of the pelvis, the occiput of the fetus is facing the symphysis, and the head is small, strong flexion of the head occurs, and labor proceeds as in an anterior occipital presentation. When the back of the fetal head is turned posteriorly, the head can be rotated 180°, so labor takes place in the anterior or posterior view. With a transversely narrowed pelvis, there is often a high erect position of the head, leading to complications and requiring a cesarean section. • Flat scorachitic pelvis •• Prolonged high standing of the head, the sagittal suture corresponds to the transverse size of the pelvis •• Slight extension of the head, as a result of which the head passes through the true conjugate (smallest size) with a small transverse size •• Asynclitic insertion of the head. Anterior asynclitism is usually observed: the posterior parietal bone rests on the promontory and lingers in this place, and the anterior one gradually descends into the pelvic cavity. After a strong configuration, the posterior parietal bone slides off the promontory and the asynclitism disappears. • Simple flat pelvis. Often there is no internal rotation of the head, because the direct dimensions of the pelvis are reduced; the sagittal suture corresponds to the transverse size of the pelvis (low transverse position of the head). If spontaneous rotation of the head does not occur, surgical delivery is necessary.

Management of labor • For III and IV degrees of narrowing, a cesarean section is indicated • Childbirth is expectant; if signs of discrepancy between the sizes of the pelvis and head appear or if complications develop, surgical intervention is indicated • Signs of compliance of the head and pelvis •• Zangemeister's sign - measure the degree of elevation of the anterior surface of the head above the symphysis. The external conjugate is measured with a pelvis, then the rear button of the pelvis is not moved, and the anterior button (located on the symphysis) is placed on the protruding point of the anterior surface of the head. The distance from the head to the suprasacral fossa should be 3–4 cm less than the external conjugate. With the same value, the discrepancy is small, the prognosis of labor is doubtful •• Vasten's sign. After the water breaks and the head is inserted, one palm is placed on the surface of the symphysis, the other on the area of the presenting head. When the sizes of the mother's pelvis and the fetal head correspond, the anterior surface of the head is located below the plane of the symphysis (Vasten's sign is negative). If the anterior surface of the head is flush with the symphysis (flush Vasten's sign), there is a slight size discrepancy. If there is a discrepancy between the sizes of the mother's pelvis and the fetal head, the anterior surface of the head is located above the plane of the symphysis (Vasten's sign is positive) •• Ultrasound • Careful monitoring of the condition of the fetus • Prevention of complications, their detection and timely treatment.

ICD-10 • O33 Medical care for the mother with established or suspected discrepancy between the sizes of the pelvis and the fetus