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Int Urogynecol J. 2013 Jul;24(7):1161-5. doi: 10.1007/s00192-012-1993-7. Epub 2012 Nov 27.

Does levator avulsion cause distension of the genital hiatus and perineal body?

Author information

1
Department of Gynaecology and Obstetrics, Trondheim University Hospital, PO Box 3250 Sluppen, 7006 Trondheim, Norway. ingridvolloyhaug@hotmail.com

Abstract

INTRODUCTION AND HYPOTHESIS:

Levator avulsion is associated with prolapse and prolapse recurrence after reconstructive surgery. We set out to determine whether clinical measurement of the genital hiatus and the perineal body (gh + pb) on maximum Valsalva can predict levator avulsion.

METHODS:

A total of 295 women attending a tertiary referral service underwent 4D translabial ultrasound imaging and clinical examination using the International Continence Society (ICS) Pelvic Organ Prolapse Quantification system (POP-Q). Analysis of ultrasound data sets for levator avulsion was performed using tomographic ultrasound imaging. The predictive performance of gh + pb for avulsion was tested using receiver-operating characteristic curves.

RESULTS:

Optimal sensitivity [70%, 95% confidence interval (CI) 59-79%] and specificity (70%, 95% CI 66-72%) were achieved with a cut-off of 8.5 cm for gh + pb.

CONCLUSIONS:

A gh + pb measurement ≥ 8.5 cm may help to identify women with levator avulsion who are at increased risk of prolapse recurrence.

PMID:
23184139
DOI:
10.1007/s00192-012-1993-7
[Indexed for MEDLINE]

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