Surgical management of pelvic floor disorders depends on a comprehensive understanding of the structural integrity and function of the pelvic floor. For visualizing this region, ultrasonography has emerged as a procedure that is relatively easy to perform, cost‐effective and widely available. In this review, pelvic floor ultrasonography, including two‐dimensional (2D), three‐dimensional (3D) and 4D imaging as well as transvaginal, endoanal and transperineal techniques, is discussed from a global and multicompartmental perspective, rather than using a compartmentalized approach. The role of the different sonographic modalities in the major disorders of the pelvic floor—urinary and fecal incontinence, pelvic organ prolapse and obstructed defecation syndrome—is evaluated critically. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.

INTRODUCTION:Amitriptyline, a tricyclic antidepressant agent with anticholinergic and serotoninergic properties, has been used empirically in the treatment of idiopathic fecal incontinence with good results.METHODS:An open study was conducted to test the response to amitriptyline 20 mg daily

Anorectal diseases require imaging for proper case management. At present, endoanal ultrasonography and endorectal ultrasonography have become important parts of diagnostic workup of patients with fecal incontinence, perianal fistulas, and rectal cancer and provides sufficient information for clinical decision-making in many cases. However, with the currently available ultrasonographic equipment and techniques, a good deal of relevant information may remain hidden. The advent of high-resolution three-dimensional endoluminal ultrasound, constructed from a synthesis of standard two-dimensional cross-sectional images, and of "Volume Render Mode," a technique to analyze information inside a three-dimensional volume by digitally enhancing individual voxels, promises to revolutionize diagnosis of pelvic floor disorders. By use of the different postprocessing display parameters, the volume-rendered image provides better visualization performance when there are not large differences in the signal levels of pathologic structures compared with surrounding tissues. The anatomic structures in the pelvis, the axial and longitudinal extension of anal sphincter defects, the anatomy of the fistulous tract in complex perianal sepsis, and the presence of slight or massive submucosal invasion in early rectal cancer may be imaged in greater detail. This additional information will bring an improvement for both planning and conduct of surgical procedures.