Biometry of the pubovisceral muscle and levator hiatus in nulliparous Chinese women

Yang, Jenn Ming; Yang, Shwu Huey; Huang, Wen‐Chen

doi:10.1002/uog.3825

Cited by 99 publications

(79 citation statements)

References 24 publications

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“…Examiners obtained the following measurements in the axial plane image corresponding to the plane of minimal antero-posterior (AP) diameter of the levator hiatus: the AP diameter of the levator hiatus (LH AP ), the right-left transverse diameter of the levator hiatus (LH T ), and the area of the levator hiatus (LH area ) (see Figure 1) according to the protocol first described by Dietz and colleagues 18 and cited in several subsequent studies. [4][5][6][7][8][9][10][11][12][13][15][16][17][19][20][21][22][23][24][26][27][28][29][30] Examiners measured each of the three volumes acquired during each task (rest, contraction, Valsalva) with each participant and calculated average measurements for each measure according to each task. Statistical analyses were performed using Excel version 12.2.7 (Microsoft Corp., Redmond, WA) and SPSS version 18.0 (SPSS Inc., Chicago, IL).…”

Section: Discussionmentioning

confidence: 99%

Pelvic Floor Ultrasound Imaging: Are Physiotherapists Interchangeable in the Assessment of Levator Hiatal Biometry?

Thibault-Gagnon

Gentilcore-Saulnier

Auchincloss

et al. 2014

Physiotherapy Canada

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Purpose: To evaluate inter-examiner reliability in the ultrasound (US) assessment of levator hiatal dimensions when different physiotherapists perform independent data acquisition and analysis. Methods: In this cross-sectional observational study, 14 asymptomatic nulliparous women were imaged at rest, during pelvic floor muscle contraction, and during Valsalva manoeuvre by two physiotherapists using three-dimensional (3D) and four-dimensional (4D) transperineal US. Examiners each measured the dimensions of the levator hiatus (area and antero-posterior and transverse diameters) from the US volumes they respectively acquired. Inter-examiner reliability was determined using intra-class correlation coefficients (ICCs), and inter-examiner agreement was determined using Bland-Altman analyses. Results: The ICC results demonstrated very good inter-examiner reliability (ICC ¼ 0.84-0.98); Bland-Altman results showed high inter-examiner agreement across all measurements. Conclusions: Trained examiners may be considered interchangeable in the US assessment of levator hiatal biometry. Overall, trained physiotherapists using transperineal US imaging to assess levator hiatal biometry can be confident when comparing their own clinical findings to those of their colleagues and to findings published in the literature.Key Words: pelvic floor; reproducibility of results; three-dimensional imaging; ultrasonography. RÉ SUMÉObjectif : Examiner la fiabilité entre examinateurs de l'é valuation é chographique des dimensions hiatales du muscle releveur de l'anus lorsque des physiothé rapeutes diffé rents procè dent à l'acquisition et à l'analyse indé pendante de donné es. Mé thodes : Au cours de cette é tude par observation transversale, 14 femmes nullipares asymptomatiques ont subi un examen d'imagerie au repos, au cours d'une contraction des muscles du plancher pelvien et durant une manoeuvre de Valsalva, effectué par deux physiothé rapeutes utilisant l'é chographie transpé riné ale tridimensionnelle (3D) et quadridimensionnelle (4D). Chaque examinateur a mesuré les dimensions du hiatus du muscle releveur (superficie et diamè tre anté roposté rieur et transversal) à partir des volumes é chographiques qu'ils ont acquis respectivement. On a dé terminé la fiabilité entre examinateurs à partir des coefficients de corré lation intra-classe (CCI) et dé terminé l'uniformité entre examinateur au moyen des analyses de Bland et d'Altman. Ré sultats : Les ré sultats de l'application des CCI ont ré vé lé une trè s bonne fiabilité entre examinateurs pour toutes les mesures. (CCI ¼ 0.84-0.98); les ré sultats de Bland et Altman ont ré vé lé une grande uniformité entre examinateurs pour toutes les mesures. Conclusions : Les examinateurs qui ont rec¸u une formation peuvent ê tre considé ré s comme interchangeables dans l'é valuation é chographique de la biomé trie hiatale du muscle releveur. Dans l'ensemble, les physiothé rapeutes qui ont suivi une formation et utilisent l'imagerie é chographique transpé riné ale pour é valuer la biomé trie hiat...

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Section: Discussionmentioning

confidence: 99%

Pelvic Floor Ultrasound Imaging: Are Physiotherapists Interchangeable in the Assessment of Levator Hiatal Biometry?

Thibault-Gagnon

Gentilcore-Saulnier

Auchincloss

et al. 2014

Physiotherapy Canada

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“…1b and d) and used for diameter and area measurements. This methodology has been shown to be repeatable and valid by ourselves [19] and several other groups [20][21][22]. and D illustrates the area of the hiatus.…”

Section: Methodsmentioning

confidence: 99%

Levator function and voluntary augmentation of maximum urethral closure pressure

Dietz

Shek

2012

Int Urogynecol J

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“…This plane is identified in the midsagittal plane by locating the minimal distance between the posteroinferior surface of the symphysis pubis and the anterior surface of the puborectalis loop behind the anorectal junction [9]. These parameters have been shown to be highly reproducible [9,22,23] by the authors and others.…”

Section: Methodsmentioning

confidence: 99%

The quantification of levator muscle resting tone by digital assessment

Dietz

Shek

2008

Int Urogynecol J

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The biomechanical properties of the puborectalis muscle are likely to be important for pelvic organ support. However, neither elasticity nor its clinical correlate, muscle resting tone, have received much attention to date. We therefore conducted a prospective study to test a newly developed resting tone scale for validity and reproducibility. Ninety-eight patients underwent a physical examination including prolapse staging and palpation of the levator ani. They were also assessed by 4D translabial ultrasound for levator hiatal dimensions and prolapse assessment. Resting tone was negatively associated with anterior and posterior compartment prolapse. An independent test-retest series yielded a weighted kappa of 0.55 (CI 0.44-0.66), implying "moderate" repeatability. Resting tone of the puborectalis muscle can be determined by digital palpation. It is moderately repeatable and associated with pelvic organ prolapse. Palpation of resting tone may be a useful new tool for assessing women with pelvic floor dysfunction.

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Biometry of the pubovisceral muscle and levator hiatus in nulliparous Chinese women

Abstract: K E Y W O R D S:

Cited by 99 publications

References 24 publications

Pelvic Floor Ultrasound Imaging: Are Physiotherapists Interchangeable in the Assessment of Levator Hiatal Biometry?

Pelvic Floor Ultrasound Imaging: Are Physiotherapists Interchangeable in the Assessment of Levator Hiatal Biometry?

Levator function and voluntary augmentation of maximum urethral closure pressure

The quantification of levator muscle resting tone by digital assessment

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