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Updated: Jun 23, 2026
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Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
Published on: April 17, 2019
The effect of levator avulsion on hiatal dimension and function
Zeelha Abdool1, Ka Lai Shek, Hans Peter Dietz
1Department of Obstetrics and Gynecology, Pretoria Academic Hospital, Pretoria, South Africa.
American Journal of Obstetrics and Gynecology
|May 12, 2009
Summary
Levator muscle avulsion, a common childbirth injury, significantly alters pelvic floor biomechanics. This trauma leads to abnormal hiatal dimensions and impaired levator muscle function, impacting pelvic floor health.
Area of Science:
- Urogynecology
- Pelvic Floor Disorders
- Musculoskeletal Biomechanics
Background:
- Vaginal childbirth can cause pelvic floor trauma, leading to significant morbidity.
- Understanding the impact of this trauma on pelvic floor structures is crucial for effective management.
Purpose of the Study:
- To investigate the association between pelvic floor trauma from vaginal delivery and abnormal hiatal biometry.
- To determine if childbirth-related trauma affects the biomechanical properties of the levator ani muscle.
Main Methods:
- Retrospective analysis of 414 urogynecologic patients' data.
- Utilized 3D/4D pelvic floor ultrasound for hiatal dimension and strain measurements.
- Clinical examination and patient interviews were also conducted.
Main Results:
- Levator muscle avulsion diagnosed in 21.1% of parous women; 8.6% had bilateral avulsion.
- Avulsion significantly increased levator muscle distensibility during Valsalva maneuver (RR 3.5-3.96).
- Avulsion reduced levator muscle shortening during pelvic floor muscle contraction.
Conclusions:
- Childbirth-related levator muscle avulsion is linked to abnormal pelvic floor biometry.
- Avulsion injury demonstrably impairs the biomechanical function of the levator ani muscle.
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