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International Urogynecology Journal

Published in:

01-06-2011 | Original Article

Minimal criteria for the diagnosis of avulsion of the puborectalis muscle by tomographic ultrasound

Authors: Hans Peter Dietz, Maria Jose Bernardo, Adrienne Kirby, Ka Lai Shek

Published in: International Urogynecology Journal | Issue 6/2011

Abstract

Introduction and hypothesis

Puborectalis avulsion is a likely etiological factor for female pelvic organ prolapse (FPOP). We performed a study to establish minimal sonographic criteria for the diagnosis of avulsion.

Methods

We analysed datasets of 764 women seen at a urogynecological service. Offline analysis of ultrasound datasets was performed blinded to patient data. Tomographic ultrasound imaging (TUI) was used to diagnose avulsion of the puborectalis muscle.

Results

Logistic regression modelling of TUI data showed that complete avulsion is best diagnosed by requiring the three central tomographic slices to be abnormal. This finding was obtained in 30% of patients and was associated with symptoms and signs of FPOP (P < 0.001). Lesser degrees of trauma (‘partial avulsion’) were not associated with symptoms or signs of pelvic floor dysfunction.

Conclusions

Complete avulsion of the puborectalis muscle is best diagnosed on TUI by requiring all three central slices to be abnormal. Partial trauma seems of limited clinical relevance.

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Title: Minimal criteria for the diagnosis of avulsion of the puborectalis muscle by tomographic ultrasound
Authors: Hans Peter Dietz
Maria Jose Bernardo
Adrienne Kirby
Ka Lai Shek
Publication date: 01-06-2011
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 6/2011
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-010-1329-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Minimal criteria for the diagnosis of avulsion of the puborectalis muscle by tomographic ultrasound

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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