Longitudinal follow‐up of levator ani muscle avulsion: does a second delivery affect it?

Chan, Ssc; Cheung, Ray C. C.; Lee, L. L.; Choy, Kwong Wai; Chung, Tony K.H.

doi:10.1002/uog.16009

Cited by 22 publications

(30 citation statements)

References 30 publications

(83 reference statements)

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“…Most of the partial eta squares were above 0.06 or even 0.14, which represents moderate or even large effect size, respectively. Previously, we reported that no difference was observed in symptoms of pelvic floor disorders or pelvic floor health-related quality of life in women with LAM avulsion at 1 year after their first delivery 9,19 . However, at 3-5 years after the first delivery, even though there was no significant increase in LAM avulsion, more women with LAM avulsion reported symptoms of stress urinary incontinence.…”

Section: Discussionmentioning

confidence: 79%

Longitudinal pelvic floor biometry: which factors affect it?

Chan

Cheung

Lee

et al. 2018

Ultrasound in Obstet & Gyne

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At 3-5 years after first delivery, a lower bladder neck, cervix and anorectal junction, and a greater HA were observed compared with findings in the first trimester and at 1 year of follow-up, regardless of parity or mode of delivery. Women with two or more VDs had a greater HA compared with those who had only one VD, and women with at least one VD had a greater HA compared with those who delivered by CS only. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

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Section: Discussionmentioning

confidence: 79%

Longitudinal pelvic floor biometry: which factors affect it?

Chan

Cheung

Lee

et al. 2018

Ultrasound in Obstet & Gyne

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“…Differences in these parameters between VM and rest represent BN mobility; larger differences indicate more obvious BN activity and weaker pelvic floor support. Levator ani muscle trauma may lead to a larger width of the HA, particularly its anterior part ( Svabik, Shek & Dietz, 2009 ), which has been found to be associated with the development of UI ( Chan et al, 2017 ). A larger β angle and HA both at rest and VM; a larger α angle, γ angle, and BNVP at VM; and a larger BND have also been found in pregnant women with UI than without UI, even after adjustment for the influence of gestational weeks, which is important because UI symptoms are more likely to occur in the last than first trimester of pregnancy ( Wesnes, Hunskaar & Rortveit, 2012 ).…”

Section: Discussionmentioning

confidence: 99%

Differences in urinary incontinence symptoms and pelvic floor structure changes during pregnancy between nulliparous and multiparous women

Luo

Chen

et al. 2017

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BackgroundThis study was performed to compare changes in urinary incontinence (UI) symptoms and pelvic floor structure during pregnancy between nulliparous and multiparous women.MethodsA cross-sectional survey was performed among pregnant women from July 2016 to January 2017. In total, 358 pregnant women from two hospitals underwent an interview and pelvic floor transperineal ultrasound assessment. A questionnaire regarding sociodemographic, gynecological, obstetric features and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) were used for the interview. Imaging data sets were analyzed offline to assess the bladder neck vertical position (BNVP), urethral angles (α, β, and γ angles), and hiatal area (HA) at rest and at maximal Valsalva maneuver (VM).ResultsAfter excluding 16 women with invalid data, 342 women were included. The prevalence (χ2 = 9.15, P = 0.002), frequency (t = 2.52, P = 0.014), usual amount of UI (t = 2.23, P = 0.029) and scores of interference with daily life (t = 2.03, P = 0.045) during pregnancy were higher in multiparous than nulliparous women. A larger bladder neck descent (BND) (F = 4.398, P < 0.001), HA (F = 6.977, P < 0.001), α angle (F = 2.178, P = 0.030), β angle (F = 4.404, P < 0.001), and γ angle (F = 2.54, P = 0.011) at VM were discovered in pregnant women with UI than without UI. Multiparous women had a significantly higher BND (t = 2.269, P = 0.024) and a larger α angle (F = 2.894, P = 0.004), β angle (F = 2.473, P = 0.014), and γ angle (F = 3.255, P = 0.001) at VM than did nulliparous women.ConclusionMultiparous women experienced more obvious UI symptoms and pelvic floor structure changes during pregnancy than did nulliparous women.

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“…Другой, более реальной причиной и доказанным фактором риска десценции тазовых органов являются влагалищные роды [43] и акушерские травмы тазового дна [44]. Распространенность перинеального травматизма, по разным данным, составляет 6,5-85% [45].…”

Section: гинекологияunclassified

Current Paradoxes in Perineology

Toktar¹,

Aryutin²,

Volkova³

et al. 2019

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Цель обзора: систематизация контраверсионных аспектов современной перинеологии и пролаптологии. Основные положения. Современная перинеология существует в условиях накопившихся парадоксальных фактов, мнений и решений, среди которых дидактический, эпидемиологический, экономический, анатомический, герниологический, тактический, эволюционный, акушерский, морфологический и другие парадоксы. Существуют два уязвимых места множества исследований, посвященных выпадению тазовых органов у женщин, которые мешают преодолеть упомянутые парадоксы. Первое из них-это представление о тазовом дне как о статичной структуре. Известно, что мышцы тазового дна рефлекторно сокращаются в ответ на любое повышение внутрибрюшного давления аналогично батуту, т. е. никогда не находятся в покое. В то же время внимание исследователей приковано в основном к соединительной ткани тазовых фасций и связок, а основной ткани, обеспечивающей функцию тазового дна-мышечной,-посвящены лишь единичные публикации. Второе уязвимое место современных научных работ-рассмотрение пролапса лишь в одной точке его развития, и, к сожалению, эта точка-конечная. Тактика оперировать только выраженный пролапс, не искать пути хирургической профилактики запутала самих исследователей. Очевидно, что следует изучать морфологические, иммуногистохимические и другие ультраструктурные характеристики тканей на этапе продромальной несостоятельности тазового дна, при синдроме широкого влагалища без манифестации пролапса, сопоставляя полученные данные с результатами применения неинвазивных методов диагностики. Заключение. Получив представление о ранних формах, а не только о выраженном пролапсе с уже сформировавшимися декомпенсаторными необратимыми изменениями тканей и анатомических взаимоотношений, можно попытаться обоснованно объяснить патогенез тазовой десценции и разрешить накопившиеся парадоксы перинеологии. Ключевые слова: пролапс тазовых органов, несостоятельность тазового дна, тазовая дисфункция, перинеология, пролаптология.

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Longitudinal follow‐up of levator ani muscle avulsion: does a second delivery affect it?

Cited by 22 publications

References 30 publications

Longitudinal pelvic floor biometry: which factors affect it?

Longitudinal pelvic floor biometry: which factors affect it?

Differences in urinary incontinence symptoms and pelvic floor structure changes during pregnancy between nulliparous and multiparous women

Current Paradoxes in Perineology

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