Pelvic Floor Disorders After Obstetric Avulsion of the Levator Ani Muscle

2019 ◽  
Vol 25 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Victoria L. Handa ◽  
Joan L. Blomquist ◽  
Jennifer Roem ◽  
Alvaro Muñoz ◽  
Hans Peter Dietz
Keyword(s):  
Pelvic Floor ◽  
Pelvic Floor Disorders ◽  
Levator Ani ◽  
Levator Ani Muscle

Establishing an Animal Model for the Evaluation of Vaginal Meshes

2009 ◽  
Author(s):  
Andrew J. Feola ◽  
Keisha Jones ◽  
Marianna Alperin ◽  
Robbie Duerr ◽  
Pam A. Moalli ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Animal Model ◽  
Pelvic Floor ◽  
Pelvic Floor Disorders ◽  
Levator Ani ◽  
The United States ◽  
Pelvic Organ ◽  
Levator Ani Muscle ◽  
Vaginal Injury

Roughly three million women in the United States give birth vaginally each year [1]. Clinically, the vagina undergoes pronounced adaptations up to the time of delivery, presumably to afford passage of the fetus [2]. Our group has suggested that if these adaptations are not sufficient or if fetus size is too large, an injury to the vagina or its supportive tissues will likely result. Vaginal injury at the time of delivery occurs quite frequently and research examining the levator ani muscle, the major muscular component of the pelvic floor, revealed injury in up to 20% of women who have given birth vaginally [3]. Therefore, vaginal birth is considered one of the greatest risk factors for pelvic floor disorders (i.e. urinary dysfunction and pelvic organ prolapse) later in life.

scholarly journals Attachment of the levator ani muscle extends to the superior ramus of the pubic bone through electrophysiological and anatomical examinations

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hung-Yen Chin ◽  
Chih-Wei Peng ◽  
Ming-Ping Wu ◽  
Chih-Hwa Chen ◽  
Yu-Ting Feng ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Pelvic Floor Muscle ◽  
Levator Ani ◽  
Pubic Bone ◽  
Levator Ani Muscle ◽  
Cadaver Dissection ◽  
Inferior Border ◽  
Stimulation Of

AbstractMyofascial pelvic pain (MFPP) of pelvic floor muscles is a common cause of chronic pelvic pain (CPP). The pathological mechanisms and treatments of MFPP are complex and still unclear until now. The levator ani muscle (LAM) is the major pelvic floor muscle. The purpose of this study was to examine the fascia and attachment of LAM through the electromyogram (EMG) and cadaver dissection. Electrophysiological stimulation of the obturator fascia above the arcus tendinous levator ani (ATLA) could trigger contraction and electrophysiological changes in LAM insertion. The LAM of embalmed adult cadavers was examined especially in the area above the ATLA. Some skeletal muscle fibers were found above the ATLA within the obturator fascia and were confirmed by Masson’s trichrome section staining. Our electromyography (EMG) and anatomical data implied that the attachment of LAM aponeurosis extended beyond ATLA to the inferior border of the superior ramus of the pubic bone. The new discovered attachment of LAM could provide a reference position for clinical diagnosis and treatment of MFPP or CPP.

scholarly journals MRI comparative study of levator ani muscle changes in nulliparous and multiparous females

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Heba Azzam ◽  
Manal Halim ◽  
Hany El-Assaly ◽  
Aya Heiba
Keyword(s):  
Pelvic Floor ◽  
Treatment Plan ◽  
Pelvic Floor Dysfunction ◽  
Levator Ani ◽  
Control Group ◽  
Puborectalis Muscle ◽  
Levator Ani Muscle ◽  
Vaginal Deliveries ◽  
Significant Difference ◽  
Muscle Changes

Abstract Background Pelvic floor dysfunction is known to be among the principal factors influencing public health, regarding frequency, cost and effect on women’s quality of life. Radiographic assessment of the pelvic floor function and anatomy plays a vital role in the recognition of pelvic floor defects. The aim of this study is to detect the postpartum-related levator ani muscle changes thus defining the relationship between the vaginal deliveries and the etiology of pelvic floor dysfunction in order to provide guidelines to decrease the incidence of pelvic floor injuries during parturition and guide the treatment plan. Results There was a significant difference in the puborectalis muscle thickness between the case and control groups in the right puborectalis (P value ≤ 0.001) and in the left puborectalis (P value (≤ 0.001) as well as significant midpoint thickness (P value = 0.03) with 46.2% puborectalis muscle injury in the case group compared with none in the control group. Conclusion Pelvic floor MRI is highly recommended as it is a contrast-free modality that allows for both anatomical and functional analysis. Its incorporation in the routine postpartum assessment will allow early detection of abnormalities even in asymptomatic cases thus ensuring proper management and preventing the development of pelvic floor dysfunction predisposed to by repeated vaginal deliveries.

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.

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