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International Urogynecology Journal
Published in: International Urogynecology Journal 5/2008

01-05-2008 | Original Article

Levator avulsion and grading of pelvic floor muscle strength

Authors: H. P. Dietz, C. Shek

Published in: International Urogynecology Journal | Issue 5/2008

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Abstract

In a retrospective study investigating the relationship between levator avulsion and clinical grading of levator ani muscle strength, we analyzed the 3D/4D translabial ultrasound and digital assessment data of 1,112 women seen in a tertiary Urogynecological clinic. Levator avulsion was diagnosed whenever the examiner was unable to palpate the insertion of the pubovisceral muscle on the inferior pubic ramus and/or whenever a discontinuity between bone and muscle was detected on ultrasound. For clinical grading of levator muscle strength, we used the modified Oxford grading. Avulsion defects were found in 252 women (23%), and this was associated with a highly significant reduction in the overall Oxford grading (2.07 vs 2.81, P < 0.001). The prevalence of avulsion increased depending on the side differences in the modified Oxford grading: from 16% when there was no difference to 76% when the side difference was 1.5 or higher (P < 0.001). Avulsion of the puborectalis muscle seems to have a marked effect on pelvic floor muscle strength, which may help in diagnosing trauma.
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Metadata
Title
Levator avulsion and grading of pelvic floor muscle strength
Authors
H. P. Dietz
C. Shek
Publication date
01-05-2008
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 5/2008
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-007-0491-9

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