International urogynecology journal · 2012
Does levator avulsion cause distension of the genital hiatus and perineal body?
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Volloyhaug I, Wong V, Shek K L, Dietz H P
Аннотация
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.
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.