Comparison of Levator Ani Muscle Defects and Function in Women with and Without Pelvic Organ Prolapse

DeLancey, John O.L.; Morgan, Daniel M.; Fenner, Dee E.; Kearney, Rohna; Guire, Kenneth E.; Miller, Janis M.; Hussain, Hero K.; Umek, Wolfgang; Hsu, Yvonne; Ashton‐Miller, James A.

doi:10.1097/01.ogx.0000265902.89309.13

Cited by 102 publications

(165 citation statements)

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“…Electrical stimulation and biofeedback could be used during the pelvic floor exercises. It had been shown that the women with POP generated less vaginal closure force during a maximal voluntary contraction than healthy women [12]. All these findings proved that pelvic floor muscle strength is the most important etiologic factor of POP.…”

Section: Discussionsupporting

confidence: 50%

Assesment of Hand grip Strength in Patients with Pelvic Organ Prolapse

Güzelant¹

2015

Ann Clin Anal Med

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ÖzetAmaç: Pelvik organ prolapsusu(POP) doğum yapmış kadınların %50'sinde gözlenen, sık bir patolojidir. Pelvik organ prolapsusunun önde gelen sebebi pelvic taban kaslarının zayıflığıdır. El kavrama gücü, total kas gücü ile ilişkili-dir ve kişinin genel kas gücünü değerlendirmek için kullanılabilir. El kavrama gücünün ölçümü Jamar dinamometre adında taşınabilir bir dinamometre ile yapılır. POP olan hastalarda genel kas gücünün azalmış olabileceği hipotezini kurduk. Gereç ve Yöntem: Namık Kemal Üniversitesi Tıp Fakültesi Jinekoloji kliniğine başvuran hastalardan, POP tanısı alan 20 hasta ve kontrol grubuna alınan 21 hasta çalışmaya alındı. POP-Q klasifikasyonu prolapsusun şiddetini değerlendirmek için kullanıldı. Jamar hidrolik el dinamometresi ile el kavrama gücü ölçüldü. Bulgular: Prolapsus grubunda medyan POP skoru 3 (1-4) idi. İki grupta ortalama Jamar Skorları sağ el için, sol el için ve dominant el için benzerdi (p=0.774, p=0.575 and p=0.707). Prolapsus grubunda ortalama vücut yağ oranı %33.9 ± 5.7 iken kontrol grubunda %38.9 ± 7.4 idi(p=0.021). Tartış-ma: Çalışmamızda POP grubu ile sağlıklı kontroller arasında genel vücut kas gücü açısından fark bulmadık. Sonuçlarımız vücudun genel kas gücünü göste-ren Jamar Skorlarının pelvik organ kas gücü ile ilişkili olmadığını göstermiştir. Anahtar KelimelerPelvik Organ Prolapsusu; El Kavrama Gücü; Kas Gücü Abstract Aim: Pelvic organ prolapse(POP) is a common condition that is observed in 50% of parous women. Weakness of pelvic floor muscles is an important factor that leads to POP. The hand grip strength is related to total muscle strength and it could be used to evaluate one's general muscle strength. The Jamar hand dynamometer is a portable dynamometer that uses a strain gauge to measure hand grip strength. We hypothesized that general muscle strength would be impaired in patients with POP. Material and Method: Twenty patients with pelvic organ prolapse and twenty-one controls were recruited from the gynecology clinic of Namik Kemal University School of Medicine. The POP-Q classification was used to quantify the clinical severity of the prolapse. Hand grip strength was measured using a JAMAR hydraulic hand dynamometer. Results: The median pelvic organ prolapse score was 3 (1-4) in prolapse group. The mean Jamar scores of both groups were similar for the right hand, the left hand and the dominant hand (p=0.774, p=0.575 and p=0.707, respectively).The mean body fat percentage was 33.9 ± 5.7 % in prolapses group and it was 38.9 ± 7.4% in control group (p=0.021). Discussion: We found no difference in terms of general muscle strength between POP group and healthy controls. Our results showed that Jamar scores, which represented general muscle strength of body, did not related to pelvic organ muscle strength.

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Section: Discussionsupporting

confidence: 50%

Assesment of Hand grip Strength in Patients with Pelvic Organ Prolapse

Güzelant¹

2015

Ann Clin Anal Med

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“…the levator ani, are evident in women with prolapse. These patients are able to generate less vaginal closure force during muscle contractions, and their genital hiatus is wider than in nonprolapsed controls (13). Overall, it appears that parturition with vaginal distention can adversely affect the integrity of gross muscular support of the levator ani, the smooth and striated muscle of the urethral and vaginal walls, and the connective tissue network crucial to pelvic visceral support.…”

Section: Changes With Prolapsementioning

confidence: 96%

Biomechanical properties of the vaginal wall: effect of pregnancy, elastic fiber deficiency, and pelvic organ prolapse

Rahn

Ruff

Brown

et al. 2008

American Journal of Obstetrics and Gynecology

120

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Objectives-To identify pregnancy-induced changes in biomechanical properties of the vaginal wall and compare these with Fibulin-5 knockout mice (Fbln5 -/-) with and without prolapse.Study Design-Mid-vaginal segments of nonpregnant and late-pregnant wild type (WT), Fbln5 -/-with prolapse, and Fbln5 -/-mice without prolapse were studied. Tissue length at failure, maximal strain, maximal stress, and tissue stiffness were determined.Results-Compared with nonpregnant mice, vaginas of pregnant and Fbln5 -/-(with prolapse) mice exhibited decreased maximal stress, increased distensibility and strain, and decreased stiffness. Tissues from Fbln5 -/-mice without prolapse were similar to nonpregnant WT animals.Conclusions-Pregnancy confers remarkable changes in the vaginal wall including increased distensibility and decreased stiffness and maximal stress. Elastinopathy alone is insufficient to cause significant changes in these properties, but prolapse confers additional alterations in distensibility and stiffness similar to those observed in pregnancy. These changes may contribute to the poor durability of many restorative surgical procedures for prolapse.

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“…Major morphological abnormalities of the puborectalis muscle ('avulsion') are likely to be an etiological factor in the development of female pelvic organ prolapse [1,2]. It is clearly related to vaginal childbirth [3,4], with Forceps delivery, length of second stage and foetal size as likely risk factors [5,6].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2010

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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.

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Comparison of Levator Ani Muscle Defects and Function in Women with and Without Pelvic Organ Prolapse

Cited by 102 publications

References 0 publications

Assesment of Hand grip Strength in Patients with Pelvic Organ Prolapse

Assesment of Hand grip Strength in Patients with Pelvic Organ Prolapse

Biomechanical properties of the vaginal wall: effect of pregnancy, elastic fiber deficiency, and pelvic organ prolapse

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

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