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International Urogynecology Journal

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01-09-2013 | Original Article

Comparison of two scoring systems for diagnosing levator ani muscle damage

Authors: T. F. M. Vergeldt, M. Weemhoff, K. J. B. Notten, A. G. H. Kessels, K. B. Kluivers

Published in: International Urogynecology Journal | Issue 9/2013

Abstract

Introduction and hypothesis

Levator defects are risk factors for pelvic organ prolapse (POP) and its recurrence. The most widely used scoring systems for severity of defects shown on magnetic resonance imaging (MRI) and perineal ultrasound (US) are not identical. The aim of this study was to investigate the differences between these classification systems with regard to levator defects on US and their clinical relevance for recurrence after prolapse surgery.

Methods

Women with previous cystocele repair underwent transperineal 3D US. Levator defects were graded according to the scoring system described with regard to MRI (DeLancey et al.) and perineal US (Dietz et al.). The results were compared using the weighted kappa and receiver operating characteristic (ROC) curves (SPSS version 20.0).

Results

We assessed 152 women. On US classification, more defects were categorized as highest grade compared with MRI classification [n = 64 (42 %) vs. n = 41 (28 %), p < 0.01]. The grades of levator defects on both scoring systems showed very good agreement, with a weighted kappa of 0.82 [95 % confidence interval (CI) 0.75–0.88). The predictive value of scoring systems for cystocele recurrence after prolapse surgery showed an area under the receiver operating curve (AUC) of 0.63 and 0.64, respectively.

Conclusions

Comparison of the two scoring systems showed good agreement but was lowest for the highest-grade defects. There was no difference in predictive value between scoring systems for cystocele recurrence after prolapse surgery.

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Title: Comparison of two scoring systems for diagnosing levator ani muscle damage
Authors: T. F. M. Vergeldt
M. Weemhoff
K. J. B. Notten
A. G. H. Kessels
K. B. Kluivers
Publication date: 01-09-2013
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 9/2013
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-013-2052-8

At a glance: The STEP trials

Springer Medicine

Comparison of two scoring systems for diagnosing levator ani muscle damage

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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