scholarly journals Association between sexual dysfunction and avulsion of the levator ani muscle after instrumental vaginal delivery

2020 ◽  
Vol 99 (9) ◽  
pp. 1246-1252
Author(s):  
José A. García‐Mejido ◽  
Irene Idoia‐Valero ◽  
Isabel M. Aguilar‐Gálvez ◽  
Carlota Borrero González ◽  
Ana Fernández‐Palacín ◽  
...  
Keyword(s):  
Sexual Dysfunction ◽  
Vaginal Delivery ◽  
Levator Ani ◽  
Levator Ani Muscle

scholarly journals Postpartum sexual function; the importance of the levator ani muscle

2020 ◽  
Vol 31 (11) ◽  
pp. 2261-2267
Author(s):  
Anne-Marie Roos ◽  
Leonie Speksnijder ◽  
Anneke B. Steensma
Keyword(s):  
Regression Analysis ◽  
Sexual Dysfunction ◽  
Pelvic Floor ◽  
Vaginal Delivery ◽  
Sexual Functioning ◽  
Pelvic Floor Muscle ◽  
Linear Regression Analysis ◽  
Levator Ani ◽  
Transperineal Ultrasound ◽  
Levator Ani Muscle

Abstract Introduction and hypothesis Pelvic floor muscle function plays an important role in female sexual functioning. Smaller genital hiatal dimensions have been associated with sexual dysfunction, mainly dyspareunia. On the other hand, trauma of the levator ani muscle sustained during childbirth is associated with increased genital hiatus, which potentially can affect sexual functioning by causing vaginal laxity. This study aims to determine the association between levator hiatal dimensions and female sexual dysfunction after first vaginal delivery. Methods This is a secondary analysis of a prospective observational study. Two hundred four women who had a first, spontaneous vaginal delivery at term between 2012 and 2015 were recruited at a minimum of 6 months postpartum. Thirteen pregnant women were excluded. We analyzed the association of total PISQ-12 score, as well as individual sexual complaints (desire, arousal, orgasm and dyspareunia), with levator hiatal dimensions at rest, with maximum Valsalva and during pelvic floor muscle contraction as measured by 4D transperineal ultrasound. Statistical analysis was performed using linear regression analysis and Mann-Whitney U test. Results One hundred ninety-one women were evaluated at a median of 11 months postpartum. There was no significant association between total PISQ-12 score and levator hiatal dimensions. Looking at individual sexual complaints, women with dyspareunia had significantly smaller levator hiatal area and anterior-posterior diameter on maximum Valsalva. By using multivariate logistic regression analysis however we found dyspareunia was not independently associated with levator hiatal dimensions. Conclusions After first vaginal delivery sexual dysfunction is not associated with levator hiatal dimensions as measured by 4D transperineal ultrasound.

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.

Computational model of levator ani muscle stretch during vaginal delivery

2006 ◽  
Vol 39 ◽  
pp. S348 ◽  
Author(s):  
L. Hoyte ◽  
P. Krysl ◽  
G. Chukkapalli ◽  
A. Majumdar ◽  
D.J. Choi ◽  
...  
Keyword(s):  
Computational Model ◽  
Vaginal Delivery ◽  
Levator Ani ◽  
Levator Ani Muscle ◽  
Muscle Stretch

Prediction Index of Levator Ani Muscle Avulsion After Vaginal Delivery: An Evidence-Based Appraisal

2018 ◽  
Vol 24 (8) ◽  
pp. 6214-6217
Author(s):  
Budi Iman Santoso ◽  
Adly Nanda Al-Fattah ◽  
Raymond Surya ◽  
Surrahman Hakim
Keyword(s):  
Pelvic Floor ◽  
Vaginal Delivery ◽  
Pelvic Floor Dysfunction ◽  
Levator Ani ◽  
Influential Factors ◽  
Cochrane Library ◽  
Levator Ani Muscle ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Levator Ani Muscle Avulsion

Pelvic floor dysfunction (PFD) due to vaginal delivery is related to tear of levator ani muscle (LAM) that potentially lead to the impairment of quality of life among women. A number of attempts to predict LAM injury after vaginal delivery had been conducted. This study aims to appraise the accuracy of several prediction index determining LAM injury after vaginal delivery. We conducted a search in Cochrane Library®, Pubmed®, and Medline® with the keywords of “pelvic floor dysfunction” AND “vaginal delivery” AND “prediction.” Critical appraisal determining the validity, importance, and applicability (VIA) was conducted by 2 independent authors. After 6 weeks to 3 months’ duration of follow up, the incidence of LAM avulsion was varied from 15.4% to 35.6% from three studies. Multivariate analysis showed that forceps delivery, OASIS, and active second stage (OR 3.8; 3.1; 1.61; respectively) as the most influential factors for LAM incidence. Maternal age and time spent in active pushing were also contributed to LAM incidence. OASIS and second stage of labor could be used as the most influential components of prediction index for LAM incidence. Prediction indexes for LAM incidence are developed. OASIS and second stage of labor are acknowledged as two most influential variables among three appraised studies.

Does episiotomy protect against injury of the levator ani muscle in normal vaginal delivery?

2013 ◽  
Vol 33 (8) ◽  
pp. 1212-1216 ◽  
Author(s):  
Jordi Cassadó ◽  
Antoni Pessarrodona ◽  
Monica Rodriguez-Carballeira ◽  
Lourdes Hinojosa ◽  
Gemma Manrique ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Levator Ani ◽  
Normal Vaginal Delivery ◽  
Levator Ani Muscle

scholarly journals MR Imaging of Levator Ani Muscle Recovery Following Vaginal Delivery

1999 ◽  
Vol 10 (5) ◽  
pp. 300-307 ◽  
Author(s):  
R. Tunn ◽  
J. O. L. DeLancey ◽  
D. Howard ◽  
J. M. Thorp ◽  
J. A. Ashton-Miller ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Vaginal Delivery ◽  
Levator Ani ◽  
Levator Ani Muscle ◽  
Muscle Recovery

The Appearance of Levator Ani Muscle Abnormalities in Magnetic Resonance Images After Vaginal Delivery

2003 ◽  
Vol 101 (1) ◽  
pp. 46-53 ◽  
Author(s):  
John O. L. DeLancey ◽  
Rohna Kearney ◽  
Queena Chou ◽  
Steven Speights ◽  
Shereen Binno
Keyword(s):  
Magnetic Resonance ◽  
Vaginal Delivery ◽  
Levator Ani ◽  
Magnetic Resonance Images ◽  
Levator Ani Muscle

scholarly journals Is obstetric anal sphincter injury a risk factor for levator ani muscle avulsion in vaginal delivery?

2017 ◽  
Vol 49 (2) ◽  
pp. 257-262 ◽  
Author(s):  
M. Simó González ◽  
J. Cassadó Garriga ◽  
C. Dosouto Capel ◽  
O. Porta Roda ◽  
J. Perelló Capó ◽  
...  
Keyword(s):  
Risk Factor ◽  
Vaginal Delivery ◽  
Anal Sphincter ◽  
Levator Ani ◽  
Obstetric Anal Sphincter Injury ◽  
Levator Ani Muscle ◽  
Sphincter Injury ◽  
Anal Sphincter Injury ◽  
Levator Ani Muscle Avulsion
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