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ultrasound organ prolapse

Ixora Kamisan Atan, Sylvia Lin, Hans Peter Dietz, Peter Herbison, Peter Donald Wilson
INTRODUCTION AND HYPOTHESIS: Levator ani muscle (LAM) and anal sphincter tears are common after vaginal birth and are associated with female pelvic organ prolapse and anal incontinence. The impact of subsequent births on LAM and external anal sphincter (EAS) integrity is less well defined. The objective of this study was to determine the prevalence of LAM and EAS trauma in primiparous (VP1) and multiparous (VP2+) women who had delivered vaginally to assess if there were differences between the two groups...
March 21, 2018: International Urogynecology Journal
Hans Peter Dietz, Francesco Scoti, Nishamini Subramaniam, Talia Friedman, Ka Lai Shek
INTRODUCTION AND HYPOTHESIS: Vaginal childbirth clearly has an effect on pelvic floor anatomy, and pregnancy itself also likely plays a role. This study investigated the effects of consecutive pregnancies by comparing pelvic organ support and function in urogynecological patients delivered by cesarean section (CS) only. METHODS: This was a retrospective study using 161 archived data sets of urogynecological patients delivered exclusively by CS presenting with symptoms of pelvic floor dysfunction between 2007 and 2015...
March 12, 2018: International Urogynecology Journal
John Graham Theisen, Nicolette E Deveneau, Anu Agrawal, Casey Kinman, Jeremy Gaskins, Kate Meriwether, Sean L Francis
OBJECTIVES: The purpose of this study was to evaluate the accuracy of portable bladder scanner postvoid residual (PVR) volume measurements in patients with pelvic organ prolapse. A secondary goal was to determine whether covariates such as bladder volume and stage of prolapse affect bladder scanner accuracy. STUDY DESIGN: Complex urodynamic studies were performed on 70 patients with stage II or greater prolapse. Complex urodynamic studies included measurement of maximum bladder capacity (MBC) as well as measurement of PVR by urethral catheterization before, and following, complex filling cystometry...
February 8, 2018: Female Pelvic Medicine & Reconstructive Surgery
Jessica Caudwell-Hall, Ixora Kamisan Atan, Chris Brown, Rodrigo Guzman Rojas, Susanna Langer, Ka Lai Shek, Hans Peter Dietz
INTRODUCTION: Levator trauma is a risk factor for development of pelvic organ prolapse. We aimed to identify antenatal predictors for significant damage to the levator ani muscle during first vaginal delivery. MATERIALS AND METHODS: A retrospective observational study utilising data from two studies with identical inclusion criteria and assessment protocols between 2005 and 2014. 1148 primiparae with an uncomplicated singleton pregnancy were recruited and assessed with translabial ultrasound at 36 weeks antepartum and 871 (76%) returned for reassessment 3-6 months postpartum...
February 2, 2018: Acta Obstetricia et Gynecologica Scandinavica
Meng Xie, Xuyin Zhang, Xiaodan Zhang, Wenping Wang, Keqin Hua
OBJECTIVES: The aim of this study was to evaluate the stiffness variation of the levator ani in patients with stage I/II pelvic organ prolapse (POP) before and after Kegel exercises by transperineal elastography. METHODS: A total of 20 patients who were diagnosed with staged I/II POP underwent conventional transperineal ultrasound and elastography. For each patient, the levator ani was located and evaluated in the state of Valsalva. After Kegel exercises for 12 weeks, transperineal ultrasound and elastography were repeated...
January 18, 2018: Journal of Medical Ultrasonics
Hans Van Geelen, Donald Ostergard, Peter Sand
The objective of this narrative review is to study the impact of pregnancy and childbirth on pelvic floor function as assessed by objective measurement techniques with quantitative data carried out during pregnancy and after childbirth. A literature search in MEDLINE and relevant and up-to-date journals from 1960 until April 2017 was performed for articles dealing with the impact of pregnancy and childbirth on pelvic floor function as assessed by objective measurement methods. Only studies describing objective measurement techniques...
January 13, 2018: International Urogynecology Journal
Sallie Oliphant, Timothy Canavan, Stacy Palcsey, Leslie Meyn, Pamela Moalli
BACKGROUND: Parity is the greatest risk factor for the development of pelvic organ prolapse. The normally supported vagina is pulled up and back over the levator ani. Loss of vaginal angulation has been associated with prolapse and may represent injury to the vaginal supportive tissues. OBJECTIVE: We proposed and examined the following hypotheses: (1) pregnancy and delivery impact vaginal support, leading to loss of vaginal angle; (2) vaginal angulation is restored postpartum; and (3) uncomplicated vaginal delivery (VD) is associated with accelerated remodeling of the vaginal fibrillar matrix...
February 2018: American Journal of Obstetrics and Gynecology
L Ramage, C Yen, S Qiu, C Simillis, C Kontovounisios, E Tan, P Tekkis
Introduction This study aimed to ascertain whether missed obstetric anal sphincter injury at delivery had worse functional and quality of life outcomes than primary repair immediately following delivery. Materials and methods Two to one propensity matching was undertaken of patients presenting to a tertiary pelvic floor unit with ultrasound evidence of missed obstetric anal sphincter injury within 24 months of delivery with patients who underwent primary repair at the time of delivery by parity, grade of injury and time to assessment...
September 15, 2017: Annals of the Royal College of Surgeons of England
Delena-Mae Caagbay, Kirsten Black, Ganesh Dangal, Camille Raynes-Greenow
BACKGROUND: Pelvic organ prolapse is a common disorder for women in Nepal causing symptoms and reduced quality of life. Pelvic floor muscle exercise is a conservative treatment option for pelvic organ prolapse but the effective way to teach women in Nepal is not known. The objective of this pilot study was to determine if an illustrative leaflet with brief verbal instruction could teach Nepali women to correctly contract their pelvic floor muscles. METHODS: Fifteen parous women attending two outpatient gynecology clinics in Kathmandu Valley were interviewed to assess their knowledge of pelvic organ prolapse and pelvic floor muscles exercise...
September 8, 2017: Journal of Nepal Health Research Council
Lieming Wen, Jing Zhang, Shi Zeng, Qichang Zhou
AIM: This study represents the first attempt to use 'Z-scores' to assess levator hiatal dimensions and quantify hiatal expansion. METHODS: We undertook a retrospective study on the data of 110 nulliparae and 73 pelvic organ prolapse (POP) patients who had a clinical POP exam and translabial 4-D ultrasound. We used Z-scores to normalize the dimensions of nulliparae levator hiatus and to build a Z-score model to evaluate the 'hiatal ballooning' against the POP staging...
October 6, 2017: Journal of Obstetrics and Gynaecology Research
X L Zhong, J Song, Y L Xu, X L Lyu, X H Zhong, A P Wang, Y F Song
Objective: To evaluate transperineal sonography for lower urinary tract symptoms after pelvic floor reconstruction. Methods: Eighty-three patients with severe pelvic organ prolapse received surgeries in Fuzhou General Hospital from September 2014 to September 2015, dividing into two groups: 27 patients were selected to receive transvaginal mesh (TVM) pelvic floor reconstruction surgery with tension-free vaginal tape-Abbrevo (TVT-Abbrevo) incontinence surgery, named TVM+TVT-Abbrevo group; 56 patients were selected to receive TVM pelvic floor reconstruction surgery only, named TVM group...
September 25, 2017: Zhonghua Fu Chan Ke za Zhi
Ismael Ortega, Nishamini Subramaniam, Talia Friedman, Friyan Turel, Hans Peter Dietz
OBJECTIVE: Digitation to void is defined as the need to apply manual pressure on the perineum or the vagina to assist with voiding. It has been associated with prolapse; however, there is little objective data concerning this symptom. Our aim was to determine the correlation between digitation to void, symptoms and signs of pelvic organ prolapse (POP), and urodynamic data. METHODS: This was a retrospective study that included a total of 1174 patients seen at a tertiary urogynecological unit...
September 13, 2017: Female Pelvic Medicine & Reconstructive Surgery
Natharnia Young, Ixora Kamisan Atan, Rodrigo Guzman Rojas, Hans Peter Dietz
INTRODUCTION AND HYPOTHESIS: The objective was to determine the association between body mass index (BMI) and symptoms and signs of female pelvic organ prolapse (POP). METHODS: An observational cross-sectional study of 964 archived datasets of women seen for symptoms and signs of lower urinary tract and pelvic organ dysfunction between September 2011 and February 2014 at a tertiary urogynaecology centre in Australia was carried out. An in-house standardised interview, the International Continence Society Pelvic Organ Prolapse Quantification (ICS POP-Q) and 4-D translabial ultrasound, followed by analysis of ultrasound volumes for pelvic organ descent and hiatal area on Valsalva, were performed, blinded against other data...
September 15, 2017: International Urogynecology Journal
Francesca Vellucci, Cristina Regini, Chiara Barbanti, Stefano Luisi
The increased life expectancy, the importance of the prevention in younger age and the role of the pelvic floor disfunction not only in the disease of the third age, but also in the childbearing age, as the influence on the type of delivery, underline the importance of the evaluation of the pelvic floor. The evaluation of pelvic floor is generally clinical, but in the last 2 decades, the use of ultrasound has become a mainstream diagnostic tool in the investigation of female pelvic organ prolapse, urinary and fecal incontinence and defecation disorders, providing an immediate objective confirmation of findings obtained on clinical examination and filling some of the gaps of the urogynecological exam...
September 5, 2017: Minerva Ginecologica
Chun Hung Yu, Symphorosa Shing Chee Chan, Rachel Yau Kar Cheung, Tony Kwok Hung Chung
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...
August 24, 2017: International Urogynecology Journal
Hans Peter Dietz, Candice Chatel, Ixora Kamisan Atan
INTRODUCTION AND HYPOTHESIS: Pelvic organ prolapse (POP) commonly presents with a "vaginal lump or bulge" and/or a "dragging sensation." The first symptom correlates strongly with clinical and imaging data. However, a "dragging sensation" may be less specific. Hence, we investigated the predictive value of both symptoms for POP. METHODS: This was a retrospective study involving archived data sets of women seen between November 2013 and May 2014. All underwent a clinical interview, POPQ examination, and 4D translabial ultrasound (TLUS)...
July 21, 2017: International Urogynecology Journal
Tomasz Kluz, Edyta Wlaźlak, Grzegorz Surkont
OBJECTIVES: Analysis of feasibility, efficacy and short-term results after six-arm transvaginal mesh OPUR implantation in women with apical prolapse. MATERIAL AND METHODS: The same surgeon operated all of 39 women using mesh OPUR. Preoperatively patients had a standardized interview and clinical examination. Intraoperative and postoperative complications were analyzed. Postoperative evaluation included standardized interview, clinical examination and standardized pelvic floor ultrasound performed with 2D transvaginal probe and 4D abdominal probe...
2017: Ginekologia Polska
Zeelha Abdool, Hans Peter Dietz, Barend Gerhardus Lindeque
INTRODUCTION AND HYPOTHESIS: There is a lack of epidemiological studies evaluating female pelvic organ prolapse in developing countries. Current studies have largely focused on women of white ethnicity. This study was designed to determine interethnic variation in pelvic floor functional anatomy, namely, levator hiatal distensibility and pelvic organ descent, in women with symptomatic pelvic organ prolapse in a multi-ethnic South African population. METHODS: This prospective observational study included 258 consecutive women referred for pelvic organ prolapse assessment and management at a tertiary urogynaecological clinic...
June 17, 2017: International Urogynecology Journal
Sissel H Oversand, Anne C Staff, Leiv Sandvik, Ingrid Volløyhaug, Rune Svenningsen
INTRODUCTION AND HYPOTHESIS: The aims of this study were to evaluate the prevalence of levator ani muscle (LAM) avulsions in a selected cohort of patients with primary anterior compartment pelvic organ prolapse (POP) and to assess whether LAM avulsions, as an independent factor, affect the degree of POP symptoms and sexual dysfunction. Additionally, clinical and demographic variables of women with and those without avulsions were compared. METHODS: We carried out a cross-sectional analysis of a prospective cohort study including 197 women scheduled for anterior compartment POP surgery...
June 15, 2017: International Urogynecology Journal
Erika J Wasenda, Ixora Kamisan Atan, Nishamini Subramaniam, Hans Peter Dietz
OBJECTIVE: To determine the effect of hormone therapy (HT) use on pelvic organ support. METHODS: A retrospective observational study involving postmenopausal women with pelvic floor dysfunction attending a tertiary urogynecology center between January 2012 and March 2015. All underwent a clinical examination including International Continence Society Pelvic Organ Prolapse Quantification and 4D translabial ultrasound imaging. Information on current or former use of systemic HT and current local estrogen use was collected...
October 2017: Menopause: the Journal of the North American Menopause Society
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