Track topics on Twitter Track topics that are important to you
The purpose of the study is to characterize the levator ani structures (pubovaginalis, puboperinealis, puboanalis, puborectalis, and the iliococcygeous) using 3-D ultrasonography in nulliparous women 21-70 years old.
Hypothesis 1: Prevalence of abnormalities in levator ani muscle structure will be associated with increasing age independent of vaginal parity. To investigate the age-related symptoms of pelvic floor dysfunction in nulliparous, women 21-70 years old.
Hypothesis 2: Anatomical abnormalities of the levator ani muscles will be associated with symptomatic pelvic floor dysfunction. To investigate the age-related pelvic floor function in nulliparous, women 21-70 years old.
Hypothesis 3: Age-related anatomical abnormalities of the levator ani muscles will be associated with levator ani muscle weakness.
This is a a cross-sectional study of age-related changes in the levator ani muscles. We will explore the 3-D anatomical architecture of these muscles in asymptomatic females ages 21-70 years old. Subjects who meet eligibility criteria will be scheduled to have a clinic study visit during which informed consent will be obtained. At this visit, subjects will be asked to complete self administered pelvic floor symptom and impact measures questionnaire (PFDI, PFIQ and PISQ-12), as well as the quality of life measure (SF-12). At the clinic study visit, a complete history will be obtained including the subject's gynecologic history including age, menopausal status, medical and surgical history by interview. A standardized examination will performed, including height, weight, and pelvic floor support assessment by using the pelvic organ prolapse quantification system (POP-Q). Body mass index will be calculated. Levator function will be assessed using the instrumented vaginal speculum. Vaginal closure force will be measured at both rest and during maximal voluntary contraction. At the completion of the exam and speculum examinations, all participants will then undergo an endovaginal 3-D ultrasound (BK medical, Wilmington, MA), at the study visit. The endovaginal ultrasound technique has been described previously. The technique is summarized as follows: A length of six cm will be scanned in 60 seconds at scans every 0.25 mm with a cumulative 240 scans from which a 3-D rendered cube will be calculated. Each 3-D cube will be digitally catalogued for future analysis. The ultrasound cubes will then be reviewed by two reviewers (LHQ and SAS), blinded to the identity of volunteers or the scores of the other reviewer. Reviewers will score muscles based on the individual muscle visualization by the origin - insertion points. The levator ani muscles in these scans will be examined for the visibility of the puboperinealis, puboanalis and pubovaginalis divisions of the levator ani muscle. Other structures, such as the superficial transverse perinei, puborectalis and iliococcygeous muscle will also be identified. A scoring system was previously developed according to the morphology and clarity of the each subdivision's origin-insertion points. The characteristic features of each levator subdivision will determined by the following two criteria: A clear and visible separation between each adjacent structure, or, Differing origin-insertion points of the muscle. An exemplary scan of a 25 year-old nulliparous women has been selected for image clarity based on the described classification method. According to the scoring system, a score of 0 given to each muscle pair corresponds to "no muscle damage" and a score of 18 corresponds to "complete muscle loss" of all subdivisions. Next, a 3-D PowerPoint library will be created describing the structures that need to be identified. The blinded reviewer may confirm the identity of the structure by manipulating the planes on the 3-D cube to trace the entire muscle subdivision to look for origin-insertion points.
Time Perspective: Cross-Sectional
University of Oklahoma Health Sciences Center
University of Oklahoma
Published on BioPortfolio: 2014-07-23T21:13:34-0400
Breech presentations (where a baby presents with feet or bottom down) have an increased risk of perinatal and neonatal complications, and are usually delivered by cesarean section. As an ...
Introduction: Urinary incontinence (UI) is considered erroneously by many as being a phenomenon of the aging process, however there is a growing prevalence of complaints of UI in nulliparo...
To compare the impact of 400-microgram self-administered vaginal versus self-administered oral misoprostol at home on preoperative cervical ripening in nulliparous women prior to outpatien...
To investigate whether vaginal dinoprostone administered before intrauterine device (IUD) insertion reduces failed insertions, insertion-related complications and pain in nulliparous women...
A multicenter prospective interventional comparative study that investigate pain management during Jaydess insertion in nulliparous women that will be tested by the analgesic affects of or...
To evaluate the influence of gestational age on induction of labour in nulliparous women.
An increasing proportion of nulliparous women are over 40 years and labor is more often induced. The aim of this study was to assess delivery outcome in women over 40 years, accounting for the interac...
Optimal management of pregnancies at 39 weeks gestational age is unknown. Therefore, we sought to perform a comparative effectiveness analysis of elective induction of labor (eIOL) at 39 weeks among n...
To explore nulliparous women's perceptions of decision making regarding mode of delivery under China's two-child policy.
The aim of this study was to analyze the position of the lumbopelvic region and the muscle activation of erector spinae and biceps femoris muscles in a group of pregnant women in the third trimester. ...
Women who are engaged in gainful activities usually outside the home.
Women licensed to practice medicine.
The concept covering the physical and mental conditions of women.
The rights of women to equal status pertaining to social, economic, and educational opportunities afforded by society.
Women who are physically and mentally abused over an extended period, usually by a husband or other dominant male figure. Characteristics of the battered woman syndrome are helplessness, constant fear, and a perceived inability to escape. (From American Heritage Dictionary of the English Language, 3d ed)
Women's Health - key topics include breast cancer, pregnancy, menopause, stroke Follow and track Women's Health News on BioPortfolio: Women's Health News RSS Women'...
Arthritis Fibromyalgia Gout Lupus Rheumatic Rheumatology is the medical specialty concerned with the diagnosis and management of disease involving joints, tendons, muscles, ligaments and associated structures (Oxford Medical Diction...
Benign Prostatic Hyperplasia (BPH) Erectile Dysfunction Urology Urology is the branch of medicine concerned with the urinary tract and diseases that affect it. Examples include urethritis, urethrostenosis and incontinence. Urology is a su...