scholarly journals Does levator ani hiatal area configuration affect pelvic organ prolapse?

2019 ◽  
Vol 54 (1) ◽  
pp. 124-127 ◽  
Author(s):  
Y. Xuan ◽  
T. Friedman ◽  
H. P. Dietz
Keyword(s):  
Pelvic Organ Prolapse ◽  
Levator Ani ◽  
Pelvic Organ ◽  
Hiatal Area

scholarly journals The Degree of Cystocele and Rectocele with Hiatal Area Levator Ani

2017 ◽  
pp. 225
Author(s):  
Fernandi Moegni ◽  
Hari Santoso
Keyword(s):  
Pelvic Organ Prolapse ◽  
Levator Ani ◽  
Pelvic Organ ◽  
Stage I ◽  
Stage Iii ◽  
Cut Point ◽  
Hiatal Area ◽  
4D Ultrasound ◽  
Significant Difference ◽  
Sensitivity Specificity

Objective: To investigate the degree of cystocele and rectocele with a maximum of levator hiatal area (AHL) during Valsava. Methods: Secondary data analysis of 90 patients with uterine prolapse January 2012 to November 2013 in the clinic Uroginekologi RSCM, Jakarta. 3D/4D ultrasound measurement and pelvic organ prolapse system Quantification (POP-Q) stage I-IV cystocele and rectocelestage I-IV. All statistical analyses were analyzed using Stata 20 for Windows. Results: Significant difference cystocele stage I-II (n = 25) with stage III-IV (n = 65), the maximum AHL with a difference of 4.33 cm2 (p = 0.040). In rectocele stage I-II (n = 64) and stage III-IV (n = 26) of 3.85 cm2 (p = 0.130). AUC values for stage I-II and III-IV cystocele was 0.607 (IK95% from 0.467 to 0.738), and the ROC for rectocele was 0.603 (IK95% from 0.472 to 0.734). The ROC optimal cut point for cystocele stage I-II with III-IV with the highestsensitivity and specificity is 29 cm2 (0.523 sensitivity, specificity 0.520), the rectocele is 30 cm2 (0.538 sensitivity, specificity 0.584). Conclusion: There is a significant relationship between the degree of cystocele and area of the levator ani muscles when Valsava, but there is no relationship at rectocele. The value of maximum area under the curve (AUC) hiatal area of the levatorani muscle in distinguishing stage I-II and III-IV cystocele are relatively similar to rectocele stage I-II and III-IV. Optimal cut point hiatal area of the levatorani muscle in distinguishing stage I-II and III-IV cystoceleis 29 cm2, while for rectocele is 30 cm2 with sensitivity and specificity values were quite good. Keywords: cystocele, levatorani hiatal area, pelvic organ prolapse, rectocele

scholarly journals The Role of Genital Hiatus (Gh), Perineal Body (Pb), Summation (Gh+Pb) of POP-Q Examination in Maximum Levator Hiatal Area of Women with Symptomatic Pelvic Organ Prolapse

2019 ◽  
pp. 130-140
Author(s):  
Kukuh W Kustarto ◽  
Fernandi Moegni
Keyword(s):  
Pelvic Organ Prolapse ◽  
Clinical Examination ◽  
Levator Ani ◽  
Pelvic Organ ◽  
Perineal Body ◽  
Pelvic Organ Prolapse Quantification ◽  
Levator Hiatus ◽  
Genital Hiatus ◽  
Hiatal Area ◽  
4D Ultrasound

Abstract Objective: to provide data on the correlation of levator hiatus area measurements in symptomatic POP using 3D / 4D Ultrasound with clinical examination of Gh, Pb and summation (Gh+Pb). Methods: Secondary data analysis of 160 POP patients examined from January 2012 to April 2017 at the Urogynecology Clinic RSCM, Jakarta. Taken data on patient characteristics, maximum 3D / 4D Ultrasound measurement of Levator Hiatus Area, and clinical measurement results using pelvic organ prolapse quantification system (POP-Q) Results: There was a positive correlation between clinical examination and measurement of hiatal area area using ultrasound with r = 0.43 for Gh length, and the medium correlation on the sum of Gh and Pb with r = 0,51. No correlation for Pb length with r = 0.23. The optimal cut to differentiate degrees 2 by 3 is 7.5 cm / 29.7 cm2 and degree 3 by 4 is 8.3 cm / 32.1 cm2. Conclusion: Clinical examination by summing the lengths of Gh and Pb may be consider reflects the examination of the hiatal area by using transperineal ultrasound to see the strain on levator ani called “ballooning” in an area with limited resources. Keywords:  genital hiatus, levator hiatus area, pelvic organ prolapse, perineal body.   Abstrak Tujuan: untuk memberikan data mengenai korelasi pengukuran area hiatus levator pada POP simtomatik mengunakan Ultrasonografi 3D/4D dengan pemeriksaan klinis yaitu panjang Gh, panjang Pb dan penjumlahannya. Metode : Analisa data sekunder sebanyak 160 pasien POP yang diperiksa dari Januari 2012 hingga April 2017 di poliklinik Urogynecology RSCM, Jakarta. Diambil data karakteristik pasien, pengukuran Ultrasonografi 3D/4D maksimal Area Hiatal Levator, dan hasil pengukuran secara klinis dengan menggunakan pelvic organ prolapse quantification system (POP-Q) Hasil : Terdapat korelasi positif antara pemeriksaan klinis dengan pengukuran luas area hiatal menggunakan USG dengan r = 0,43 untuk panjang Gh, dan korelasi pada penjumlahan Gh dan Pb dengan r=0,51 termasuk kategori sedang, sedangkan untuk panjang Pb dengan r = 0,23 tidak didapatkan adanya korelasi. Didapatkan titik potong optimal untuk membedakan derajat 2 dengan derajat 3 adalah 7,5 cm / 29,7 cm2 dan derajat 3 dan derajat 4 adalah 8,3 cm / 32,1 cm2 Kesimpulan : Pemeriksaan klinis dengan menjumlahkan panjang Gh dan panjang Pb dapat dipertimbangkan untuk mencerminkan pemeriksaan area hiatal dengan mengunakan USG 3 / 4 dimensi transperineal pada daerah dengan sarana terbatas untuk melihat regangan pada levator ani atau yang disebut sebagai “ballooning Kata kunci : badan perineum, genital hiatus, hiatal levator ani, prolaps organ panggul.

scholarly journals Animal models for pelvic organ prolapse: systematic review

2021 ◽  
Author(s):  
Marina Gabriela M. C. Mori da Cunha ◽  
Katerina Mackova ◽  
Lucie Hajkova Hympanova ◽  
Maria Augusta T. Bortolini ◽  
Jan Deprest
Keyword(s):  
Pelvic Organ Prolapse ◽  
Animal Models ◽  
Vaginal Delivery ◽  
Structural Changes ◽  
Meta Analysis ◽  
Levator Ani ◽  
Complete Recovery ◽  
Pelvic Organ ◽  
Squirrel Monkeys ◽  
Levator Ani Muscle

Abstract Introduction and hypothesis We aimed to summarize the knowledge on the pathogenesis of pelvic organ prolapse (POP) generated in animal models. Methods We searched MEDLINE, Embase, Cochrane and the Web of Science to establish what animal models are used in the study of suggested risk factors for the development of POP, including pregnancy, labor, delivery, parity, aging and menopause. Lack of methodologic uniformity precluded meta-analysis; hence, results are presented as a narrative review. Results A total of 7426 studies were identified, of which 51 were included in the analysis. Pregnancy has a measurable and consistent effect across species. In rats, simulated vaginal delivery induces structural changes in the pelvic floor, without complete recovery of the vaginal muscular layer and its microvasculature, though it does not induce POP. In sheep, first vaginal delivery has a measurable effect on vaginal compliance; measured effects of additional deliveries are inconsistent. Squirrel monkeys can develop POP. Denervation of their levator ani muscle facilitates this process in animals that delivered vaginally. The models used do not develop spontaneous menopause, so it is induced by ovariectomy. Effects of menopause depend on the age at ovariectomy and the interval to measurement. In several species menopause is associated with an increase in collagen content in the longer term. In rodents there were no measurable effects of age apart of elastin changes. We found no usable data for other species. Conclusion In several species there are measurable effects of pregnancy, delivery and iatrogenic menopause. Squirrel monkeys can develop spontaneous prolapse.

scholarly journals OP18.05: Hiatal area and pelvic floor distress inventory scoring in Chinese pelvic organ prolapse women

2013 ◽  
Vol 42 (s1) ◽  
pp. 99-99
Author(s):  
S. S. Chan ◽  
R. Cheung ◽  
A. Yiu ◽  
L. Lee ◽  
Y. Yiu
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Pelvic Organ ◽  
Hiatal Area

Levator ani subtended volume: a novel parameter to evaluate levator ani muscle laxity in pelvic organ prolapse

2012 ◽  
Vol 206 (3) ◽  
pp. 244.e1-244.e9 ◽  
Author(s):  
Antonio Antunes Rodrigues ◽  
Renee Bassaly ◽  
Mona McCullough ◽  
H. Leigh Terwilliger ◽  
Stuart Hart ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Levator Ani ◽  
Pelvic Organ ◽  
Levator Ani Muscle

Prevalence of levator ani muscle avulsion and effect on quality of life in women with pelvic organ prolapse

2017 ◽  
Vol 29 (5) ◽  
pp. 729-733 ◽  
Author(s):  
Chun Hung Yu ◽  
Symphorosa Shing Chee Chan ◽  
Rachel Yau Kar Cheung ◽  
Tony Kwok Hung Chung
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Levator Ani ◽  
Pelvic Organ ◽  
Levator Ani Muscle ◽  
Levator Ani Muscle Avulsion

scholarly journals Transperineal ultrasound to estimate the appropriate ring pessary size for women with pelvic organ prolapse

2021 ◽  
Author(s):  
Claudia Manzini ◽  
Mariëlla I. J. Withagen ◽  
Frieda van den Noort ◽  
Anique T. M. Grob ◽  
Carl H van der Vaart
Keyword(s):  
Pelvic Organ Prolapse ◽  
Operating Characteristic ◽  
Pelvic Organ ◽  
Transperineal Ultrasound ◽  
Small Ring ◽  
Receiver Operating Characteristic Curves ◽  
Ring Pessary ◽  
Hiatal Area ◽  
Significant Difference ◽  
Control Study

Abstract Introduction and hypothesis The objective was to predict the successful ring pessary size based on the levator hiatal area (HA). Methods This is a prospective case–control study. Women with symptomatic pelvic organ prolapse (POP) choosing pessary treatment were included. All women underwent an interview, clinical examination, and 3D/4D transperineal ultrasound (TPUS). The ring pessary size used in each trial and the reason for unsuccessful trials were recorded. In addition, levator hiatal area divided by ring pessary size (HARP ratio) was measured at rest, maximum contraction, and maximum Valsalva. The HARP ratios of successful and unsuccessful trials were compared, receiver operating characteristic curves in the prediction of successful trials were constructed, and the cut-off optimizing sensitivity and specificity was identified. Results A total of 162 women were assessed and 106 were included with 77 successful trials, 49 unsuccessful trials owing to dislodgment or failure to relieve POP symptoms, and 20 unsuccessful trials owing to pain/discomfort. Rest HARP ratio and Valsalva HARP ratio were significantly smaller in the successful trials versus dislodgment/failure to relieve POP symptoms trials (mean rest HARP ratio [SD]: 2.93 [0.59] vs 3.24 [0.67], p = 0.021; median Valsalva HARP ratio (IQR): 4.65 (1.56) vs 5.32 (2.08), p = 0.004). No significant difference was observed between pain/discomfort trials and successful trials. The best cut-off for the prediction of successful trials was Valsalva HARP ratio ≤ 5.00. Conclusions Unsuccessful fitting trials due to dislodgment/failure to relieve POP symptoms are associated with a small ring pessary with respect to the levator HA. A ring pessary that produces a Valsalva HARP ratio > 5.00 has a higher risk of dislodgment/failure to relieve POP symptoms.

Sign in / Sign up

Export Citation Format

Share Document