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Aust N Z J Obstet Gynaecol. 2014 Jun;54(3):206-11. doi: 10.1111/ajo.12171. Epub 2014 Feb 18.

The use of 3-dimensional ultrasound of the pelvic floor to predict recurrence risk after pelvic reconstructive surgery.

Author information

1
Sydney Medical School Nepean, Penrith, New South Wales, Australia.

Abstract

AIMS:

Female pelvic organ prolapse is a common condition. Prolapse recurrence following surgical treatment is a significant clinical issue. The aim of this study was to determine risk factors for recurrence, attempting to improve clinical practice by allowing better patient selection prior to surgery.

METHODS:

This was a retrospective study utilising patient records and ultrasound volume imaging data sets obtained in four clinical audits following anterior colporrhaphy ± mesh. Prolapse recurrence was diagnosed clinically and by ultrasound; findings were analysed against potential predictors.

RESULTS:

Symptomatic prolapse recurrence was demonstrated in 86 (26%), on clinical examination in 141 (42%) and on ultrasound in 113/334 women (34%). None of the tested predictors were predictive of recurrent symptoms, likely due to a lack of power. However, both levator avulsion and hiatal area on Valsalva were shown to be highly significant predictors of objective prolapse recurrence on clinical examination and ultrasound.

CONCLUSIONS:

Prolapse recurrence following surgery is a common complaint. The state of the patient's pelvic floor muscle seems to be the strongest determinant.

KEYWORDS:

4D-ultrasound; Hiatal ballooning; levator avulsion; pelvic floor muscle; pelvic organ prolapse

PMID:
24576013
DOI:
10.1111/ajo.12171
[Indexed for MEDLINE]

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