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Published in: International Urogynecology Journal 5/2018

01-05-2018 | Original Article

Prevalence of levator ani muscle avulsion and effect on quality of life in women with pelvic organ prolapse

Authors: Chun Hung Yu, Symphorosa Shing Chee Chan, Rachel Yau Kar Cheung, Tony Kwok Hung Chung

Published in: International Urogynecology Journal | Issue 5/2018

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Abstract

Introduction and hypothesis

Levator ani muscle (LAM) avulsion is associated with pelvic organ prolapse (POP). There is limited information on the prevalence of LAM avulsion in Chinese women with POP. This study evaluated the prevalence of LAM avulsion in women presenting with POP and the effects on their quality of life (QoL).

Methods

This prospective study was conducted in a tertiary urogynecology center. Chinese women presenting with POP were recruited and completed standardized questionnaires exploring their symptoms and QoL and underwent gynecological examination to assess the stage of POP and involved compartments. Four-dimensional translabial ultrasound (US) was performed on all women, and evaluation of LAM avulsion was done offline.

Results

Three hundred and ninety-eight women completed the study. The prevalence of LAM avulsion was 38.9% [95% confidence interval (CI) 34.1–43.7%]; 31 (7.8%), 26 (6.5%), and 98 (24.6%) had left, right, and bilateral LAM avulsion, respectively. LAM avulsion was associated with a more advanced stage of prolapse (P < 0.005) and prolapse of stage ≥II of all three compartments. Bilateral LAM avulsion was associated with a more severe stage of prolapse. More women with LAM avulsion reported bothersome symptoms of prolapse and had higher Pelvic Organ Prolapse Distress Inventory (POPDI) and Urinary Incontinence Questionnaire (UIQ) scores, implying more impairment in QoL. However, after multivariate linear regression analysis, POP stage remained a significant predictor of POPDI and UDI scores (P ≤ 0.006); LAM avulsion was not a predictor (P = 0.2 and 0.27, respectively).

Conclusions

LAM avulsion was detected in 39% of Chinese women with POP. It was associated with a more advanced POP stage, and these women had more impairment of QoL. However, LAM avulsion was not an independent factor influencing the QoL of these women.
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Metadata
Title
Prevalence of levator ani muscle avulsion and effect on quality of life in women with pelvic organ prolapse
Authors
Chun Hung Yu
Symphorosa Shing Chee Chan
Rachel Yau Kar Cheung
Tony Kwok Hung Chung
Publication date
01-05-2018
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 5/2018
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-017-3454-9

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