This study aims to evaluate vaginal laxity and bladder neck descent in women who have given birth, using non-invasive 2D and 3D transperineal ultrasound. Participants will complete a short questionnaire about pelvic floor symptoms and undergo a pelvic examination. The ultrasound will measure bladder neck position, levator hiatus dimensions, and related pelvic floor structures at rest and during straining. The study will compare findings between women with previous vaginal deliveries and those who had cesarean sections. Participation is voluntary, and all procedures are safe, non-invasive, and similar to routine clinical practice. The results will help better understand pelvic floor changes after childbirth and may improve the management of pelvic floor disorders.

Pelvic floor dysfunction is a common condition affecting women after childbirth, often resulting in vaginal laxity, bladder neck descent, and related pelvic floor symptoms such as urinary incontinence and sexual dysfunction. This observational cross-sectional study will assess 185 parous women, aged 18 years or older, using both 2D and 3D transperineal ultrasound. Participants will complete the Pelvic Floor Distress Inventory-20 questionnaire and undergo a pelvic examination using the POP-Q system after bladder emptying. Ultrasound measurements will include bladder neck height, retrovesical angle, levator hiatal dimensions, levator ani muscle integrity, and other related parameters at rest and during Valsalva maneuver. Women will be categorized based on mode of delivery (vaginal vs cesarean) and results will be analyzed to determine correlations between pelvic floor anatomy and symptom severity. The study aims to provide a comprehensive understanding of pelvic floor alterations in parous women, which may inform clinical assessment and management strategies for pelvic floor dysfunction.

Inclusion Criteria:

• Parous women aged 18 years or older
• Willing to provide informed consent
• Able to complete the Pelvic Floor Distress Inventory-20 questionnaire
• Undergo 2D and 3D transperineal ultrasound and POP-Q examination

Exclusion Criteria:

• Pregnant women
• History of previous prolapse surgery
• Patients with neurological disorders affecting pelvic floor function

Only biologically female participants are eligible for this study. Eligibility is based on sex assigned at birth, not on gender identity. Participants must have given birth (parous women) and meet other inclusion criteria. Transgender men or non-binary individuals assigned female at birth who meet the parous criteria may be considered, but the study focuses primarily on women who have experienced vaginal or cesarean deliveries.

The study population consists of parous women attending the Women's Health Hospital, Urogynecology and Advanced Ultrasound units. Participants will include women with at least one vaginal delivery or only cesarean deliveries, aged 18 years or older. They will be recruited to assess pelvic floor function and anatomical changes using 2D and 3D transperineal ultrasound.