Pelvic Organ Prolapse as a Function of Levator Ani Avulsion, Hiatus Size, and Strength

2019 ◽  
Vol 74 (10) ◽  
pp. 588-590
Author(s):  
Victoria L. Handa ◽  
Jennifer Roem ◽  
Joan L. Blomquist ◽  
Hans Peter Dietz ◽  
Alvaro Muñoz
Keyword(s):  
Pelvic Organ Prolapse ◽  
Levator Ani ◽  
Pelvic Organ ◽  
Levator Ani Avulsion

scholarly journals Pelvic organ prolapse as a function of levator ani avulsion, hiatus size, and strength

2019 ◽  
Vol 221 (1) ◽  
pp. 41.e1-41.e7 ◽  
Author(s):  
Victoria L. Handa ◽  
Jennifer Roem ◽  
Joan L. Blomquist ◽  
Hans Peter Dietz ◽  
Alvaro Muñoz
Keyword(s):  
Pelvic Organ Prolapse ◽  
Levator Ani ◽  
Pelvic Organ ◽  
Levator Ani Avulsion

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.

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 Correlation of levator ani muscle strength measurement between Modified Oxford Grading Scale and perineometer on pelvic organ prolapse patient

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Fernandi Moegni ◽  
Ingrid Felicia Ocsilia Wengkang
Keyword(s):  
Pelvic Organ Prolapse ◽  
Muscle Strength ◽  
Levator Ani ◽  
Pelvic Organ ◽  
Levator Ani Muscle ◽  
Moderate Pressure ◽  
Cross Sectional ◽  
Digital Palpation ◽  
Grading Scale ◽  
Spearman Test

Pelvic Organ Prolapse (POP) is a debilitating condition affecting about half of all women aged of more than 60 years globally. Reduced levator ani muscle strength in POP is associated with worse symptoms and prognosis. Measurement of levator ani muscle strength can be done with several tools such as perineometer and digital palpation. However, there is currently no study regarding conformity between tests. The aim of this study is to determine the correlation between tests in POP patients. An analytic observational study using cross sectional design was done to determine conformity between perineometer and digital examination using Modified Oxford Grading Scale (MOS) in Dr Cipto Mangunkusumo National General Hospital, Indonesia during the period of July, 2018 to June, 2020. Correlation between tests was determined using Spearman test. Cut-off of perineometer reading for each MOS score was also determined. A total of 110 subjects examined with both perineometer and digital palpation were recruited to the study. Positive correlation was observed between perineometer reading and Modified Oxford Grading Scale (r = 0.790, p < 0.001). According to the result, values between 0.01 – 9.64 cmH2O correspond to very weak pressure (MOS 1); 9.65 – 22.49 cmH2O represent weak pressure (MOS 2); 22.5 – 35.24 cmH2O represent moderate pressure (MOS 3); ≥ 35.25 cmH2O represent good pressure (MOS 4). There was a strong correlation between MOS and perineometer result for measuring levator ani strength in POP patients.

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

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