METHODS: One hundred fifty-seven women with pelvic organ prolapse participated in this cross-sectional study. Participants answered a symptom questionnaire and underwent clinical and three- and four-dimensional transperineal ultrasound examination. Pelvic floor muscle maximum voluntary contraction (MVC), endurance, and resting vaginal pressure were registered with a vaginal balloon catheter. Offline analyses were performed for the presence of major pubovisceral muscle defects (PVMD) and hiatal dimensions.
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RESULTS: The levator hiatus dimensions at rest and contraction were significantly larger in women with than without major PVMD. Mean differences in levator hiatus area between women with and without major PVMD were: rest 1.9 cm2 95% confidence intervals (CI) 0.21-3.7, P = 0.028 and contraction 2.75 cm2 95% CI 1.0-4.5, P =0.002; and Valsalva maneuver mean difference was 0.82 cm2 95% CI 2.18-3.83, P = 0.543. Women with major PVMD had lower MVC and endurance measurements as compared with women without major PVMD, but the differences were not statistically significant.
CONCLUSIONS: Women with major pubovisceral muscle defects have larger hiatal dimensions at rest and at contraction than women without PVMD. We were unable to prove the corresponding relationship for hiatal dimensions on Valsalva.
Majida M, Brækken IH, Bø K, Engh ME. Are you the author?
Department of Obstetrics and Gynaecology, Akershus University Hospital, Post-Box 24, 1478, Lørenskog, Norway.
Reference: Int Urogynecol J. 2012 Jan 14. Epub ahead of print.