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- W2019037246 abstract "Levator avulsion is a common consequence of vaginal delivery, as shown in studies using magnetic resonance and ultrasound imaging. In this study we set out to determine the odds ratio of major morphological abnormalities of the levator ani muscle in women with prolapse, and the relative risk of significant prolapse in women with levator avulsion. Some 801 women were seen in a tertiary urogynecological unit. They were assessed with a standardized interview, an examination using the ICS POP-Q staging system, and assessment of the levator ani muscle by 3D/4D translabial ultrasound (n = 350) and/or digital assessment (n = 780); 789 women could be assessed by at least one method. Mean age was 55.3 (17.9–90.8) years, median parity was 2 (0–12). Patients complained of stress incontinence (79%), urge incontinence (76%) and prolapse (28%). Levator defects were found in 172 women (21.8%). Significant prolapse (reaching at least 1 cm beyond the hymen) was diagnosed in 452 women (57.3%). When women with previous incontinence or prolapse surgery were excluded, leaving 697 datasets, unilateral defects were found in 23/296 (7.7%) of women without, and in 130/401 (32.4) of women with significant prolapse, yielding an odds ratio of 5.7 (confidence interval, 3.5–9.1). For bilateral defects figures were 7/296 (2.4%) in women without, and 40/401 (10.0%) in women with significant prolapse, giving an odds ratio of 4.6 (CI, 2–10.3). When the dataset was analyzed to obtain the relative risk of significant prolapse dependent on levator defects, the RR was 1.7 (CI, 1.5–1.9). Women with significant clinical pelvic organ prolapse are 4–6 times more likely to show evidence of levator avulsion than those without. Furthermore, it appears that the presence of a levator defect in our population increases the risk of significant prolapse by approximately 70%. It remains to be shown to what extent these results are applicable to the general population." @default.
- W2019037246 created "2016-06-24" @default.
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- W2019037246 date "2007-09-21" @default.
- W2019037246 modified "2023-10-11" @default.
- W2019037246 title "OC255: Female pelvic organ prolapse and levator trauma" @default.
- W2019037246 doi "https://doi.org/10.1002/uog.4361" @default.
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