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Ultrasound Obstet Gynecol. 2010 Jul;36(1):76-80. doi: 10.1002/uog.7678.

Levator avulsion is a risk factor for cystocele recurrence.

Author information

  • 1Sydney Medical School Nepean, University of Sydney, Nepean Hospital, Penrith, Australia. hpdietz@bigpond.com

Erratum in

  • Ultrasound Obstet Gynecol. 2011 Apr;37(4):500.

Abstract

OBJECTIVES:

To determine whether levator avulsion is a risk factor for recurrence after cystocele repair.

METHODS:

This was an audit of women who underwent anterior colporrhaphy at a tertiary hospital between 2002 and 2005, who were followed up by interview, clinical examination and four-dimensional translabial ultrasound examination 3-6 years later.

RESULTS:

Of 242 patients identified through theater records we were able to contact 171 (71%). Of 83 who agreed to attend, 24 (29%) reported symptoms of recurrent prolapse. There were 33 (40%) recurrent cystoceles (ICS POP-Q ≥ 0), [corrected] and 34 (41%) had a significant cystocele on ultrasound examination. On pelvic floor tomographic ultrasound examination, a levator avulsion was detected in 29 (35%) patients. The relative risk of recurrence in women with avulsion was 3.9 (95% CI, 2.4-5.8) when ultrasound criteria of recurrent cystocele were used, and 2.9 (95% CI, 1.7-4.5) when using clinical staging.

CONCLUSION:

Levator avulsion is associated with a relative risk of 3-4 for cystocele recurrence after anterior colporrhaphy.

Copyright 2010 ISUOG. Published by John Wiley & Sons, Ltd.

PMID:
20499408
[PubMed - indexed for MEDLINE]
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