Update on Diagnosis and Treatment for Levator Avulsion

Levator avulsion (LA) is common during vaginal birth and is the principal etiological factor for the development of pelvic floor dysfunction. Most described nonsurgical treatments for LA in the literature are pelvic floor muscle exercises and pessary. Long-term benefits of conservative treatments in women with major LA are not clear. Research investigating surgeries for LA are scarce and engaging in heterogeneous procedures, such as reattachment of the levator ani muscle to the inferior pubic bone, reattachment of the levator ani muscle to the arcus tendineus of levator ani, and standard pelvic floor repairs for pelvic organ prolapse, with or without mesh. Currently, there is no consensus on the most appropriate treatment for women with LA. This article intends to discover the effective treatment for LA from the literature.