Related Experiment Video
Updated: Jul 16, 2026
Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
Published on: April 17, 2019
Validating a clinical measure of levator hiatus size
Sarah Hamilton Boyles1, S Renee Edwards, W Thomas Gregory
1Oregon Health & Science University, Portland, OR, USA.
Objective:
We evaluate the interrater reliability of levator hiatus (LH) size and correlate size to other measures of muscle function.
Study Design:
Participants were examined independently by 2 examiners. During maximal contraction of the levator ani, the muscle was assessed by using Brink's scale. The LH was measured in the transverse and sagittal dimensions by digital palpation. The paired t test was used to compare continuous variables and Spearman's coefficient was used for correlations.
Results:
The mean LH transverse was 4.5 cm and the mean LH sagittal was 3 cm. The inter-rater correlation for the LH transverse measurement was 0.6 (P < .01) and 0.8 (P < .01) for the LH sagittal measurement. The correlations between the LH size and Brink's scale were moderate (correlation coefficient -0.4 to -0.5, P < .01). Eighty-three percent of measurements were within 1 cm.
Conclusion:
This technique for clinical measurement of levator hiatus size shows good interrater reliability.
