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Updated: May 26, 2026
07:41
Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
Published on: April 17, 2019
Obstetric levator ani muscle injuries: current status.
N Schwertner-Tiepelmann1, R Thakar, A H Sultan
1Croydon University Hospital, Croydon, UK.
Summary
Levator ani muscle (LAM) injuries affect many women after vaginal birth. Ultrasound is a practical tool for diagnosing these injuries, which impact pelvic floor strength and quality of life.
Area of Science:
- Obstetrics and Gynecology
- Pelvic Floor Imaging
- Women's Health
Background:
- Levator ani muscle (LAM) injuries are common after vaginal delivery, affecting 13-36% of women.
- Magnetic resonance imaging (MRI) initially described these injuries, but ultrasound is now a more accessible alternative.
- LAM injuries can lead to reduced pelvic floor strength, vaginal hiatus enlargement, and pelvic organ prolapse.
Purpose of the Study:
- To review the current understanding of levator ani muscle injuries.
- To highlight the role of ultrasound in diagnosing LAM injuries.
- To identify gaps in research regarding LAM injury consequences and diagnosis.
Main Methods:
- Review of existing literature on LAM injuries and their diagnosis.
- Comparison of imaging modalities, including MRI and 3D transperineal/endovaginal ultrasound.
- Discussion of the clinical implications of LAM injuries.
Main Results:
- Ultrasound offers a readily available and economic method for assessing LAM morphology.
- Evidence linking LAM injuries to stress urinary incontinence is inconclusive; a trend towards fecal incontinence exists.
- Longitudinal studies and validated quality-of-life assessments are lacking.
Conclusions:
- Further direct comparative studies are needed to establish a gold standard for diagnosing LAM injuries.
- Consistent definitions and classifications are required for accurate diagnosis and risk identification.
- Preventive strategies in obstetric practice could be improved with better understanding and diagnosis of LAM injuries.
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