Levator defects are associated with prolapse after pelvic floor surgery.
Summary of "Levator defects are associated with prolapse after pelvic floor surgery."
Pelvic organ prolapse recurrence after pelvic floor surgery is a common problem. This study was designed to assess whether avulsion defects of the puborectalis muscle are associated with recurrent pelvic organ prolapse and its symptoms. STUDY
We retrospectively evaluated 737 data sets of patients who had presented to a tertiary urogynaecology unit with symptoms of pelvic floor dysfunction. All underwent a standardised interview including a surgical history, a clinical examination and 4D pelvic floor ultrasound. Avulsion injury was diagnosed on tomographic ultrasound. The prevalence of pelvic organ prolapse and its symptoms was calculated for patients with previous hysterectomy and previous anti-incontinence and prolapse surgery, with and without confirmed avulsion injury.
Out of 737 patients, 248 (33.6%) reported a previous hysterectomy, 165 patients (22.4%) had undergone incontinence or prolapse procedures, 106 (14.4%) reported a previous anterior colporrhaphy, and 45 patients (6.1%) had undergone a colposuspension in the past. In all four groups avulsion injury was significantly associated with objective prolapse (relative risks between 2.3 and 3.3, odds ratios between 3.4 and 6). Symptoms of prolapse were significantly associated with avulsion injury post hysterectomy, incontinence or prolapse procedures and after anterior colporrhaphy.
Avulsion injury of the puborectalis muscle is associated with prolapse in women with previous pelvic floor surgery.
Nepean Clinical School, University of Sydney, Penrith, Australia.
This article was published in the following journal.
Name: European journal of obstetrics, gynecology, and reproductive biology
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20832929
- DOI: http://dx.doi.org/10.1016/j.ejogrb.2010.07.046
Medical and Biotech [MESH] Definitions
Soft tissue formed mainly by the pelvic diaphragm, which is composed of the two levator ani and two coccygeus muscles. The pelvic diaphragm lies just below the pelvic aperture (outlet) and separates the pelvic cavity from the PERINEUM. It extends between the PUBIC BONE anteriorly and the COCCYX posteriorly.
Pelvic Organ Prolapse
Abnormal descent of a pelvic organ resulting in the protrusion of the organ beyond its normal anatomical confines. Symptoms often include vaginal discomfort, DYSPAREUNIA; URINARY STRESS INCONTINENCE; and FECAL INCONTINENCE.
Inflammation of the parametrium, the connective tissue of the pelvic floor, extending from the subserous coat of the uterus laterally between the layers of the BROAD LIGAMENT.
The prolapse or downward displacement of the VISCERA.
The part of the pelvis, inferior to the pelvic brim, that comprises both the pelvic cavity and the part of the PERINEUM lying inferior to the PELVIC DIAPHRAGM.
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