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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
Are bony pelvis dimensions associated with levator ani defects? A case-control study.
Mitchell B Berger1, Stergios K Doumouchtsis, John O Delancey
1Pelvic Floor Research Group, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA. mitcberg@umich.edu
International Urogynecology Journal
|January 12, 2013
Summary
Severe levator ani defects (LAD) in women are linked to a shorter sacrococcygeal joint-to-infrapubic point (SCIPP) length. Forceps delivery also predicts these defects, impacting pelvic floor function.
Area of Science:
- Pelvic anatomy and biomechanics
- Women's health and pelvic floor disorders
- Medical imaging and diagnostics
Background:
- Pelvic floor dysfunction is associated with variations in bony pelvis dimensions.
- Levator ani defects (LAD) represent a significant cause of pelvic floor dysfunction.
Purpose of the Study:
- To compare bony pelvis dimensions between women with severe bilateral LAD and those with normal levator ani muscles.
- To identify specific pelvic measurements associated with severe levator ani defects.
Main Methods:
- Secondary analysis of a case-control study involving women with and without pelvic organ prolapse.
- Pelvic organ prolapse quantification (POP-Q) and pelvic MRI were utilized.
- Measurements included subpubic angle, interspinous/intertuberous diameters, and sacrococcygeal joint-to-infrapubic point (SCIPP) length.
Main Results:
- Women with severe bilateral LAD had a significantly shorter SCIPP length compared to controls (P=0.02).
- A shorter SCIPP length was also observed in women with prolapse and severe LAD (P=0.01).
- SCIPP length and forceps delivery history were independent predictors of severe bilateral LAD.
Conclusions:
- Shorter SCIPP length is associated with severe bilateral levator ani defects.
- Forceps-assisted vaginal delivery is a significant predictor of severe bilateral LAD.
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