Association between pelvic organ prolapse types and levator‐urethra gap as measured by 3D transperineal ultrasound

Objectives To evaluate the association between pelvic organ prolapse (POP) types and levator‐urethra gap (LUG) as measured by 3‐dimensional transperineal tomographic ultrasound. Methods A retrospective study was carried out on 98 women with symptomatic POP. Three‐dimensional transperineal tomographi...

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Bibliographic Details
Published in:Journal of ultrasound in medicine 2018-12, Vol.37 (12), p.2849-2854
Main Authors: Kozma, Bence, Larson, Kindra, Scott, Lauren, Cunningham, Tina D., Abuhamad, Alfred, Poka, Robert, Takacs, Peter
Format: Article
Language:English
Subjects:
Body Weights and Measures - methods
Cohort Studies
Female
Humans
Imaging, Three-Dimensional - methods
levator ani avulsion
levator‐urethra gap
Middle Aged
Pelvic Floor - diagnostic imaging
pelvic organ prolapse
Pelvic Organ Prolapse - diagnostic imaging
Perineum - diagnostic imaging
Retrospective Studies
transperineal ultrasound
Ultrasonography - methods
Urethra - diagnostic imaging
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Summary:Objectives To evaluate the association between pelvic organ prolapse (POP) types and levator‐urethra gap (LUG) as measured by 3‐dimensional transperineal tomographic ultrasound. Methods A retrospective study was carried out on 98 women with symptomatic POP. Three‐dimensional transperineal tomographic ultrasound images and POP quantification coordinates were reviewed. Each vaginal compartment was staged for the degree of prolapse, and total number of involved compartments identified. LUG was measured on 3‐dimensional tomographic sonograms as the distance between the center of the urethra and the levator insertion bilaterally. Based on prior studies, an abnormal LUG of 25 mm or greater indicated levator avulsion. The LUG and the presence or absence of unilateral/bilateral avulsions was analyzed with reference to the clinical diagnosis of prolapse (single versus multicompartment, and mild [stage II] versus severe [stage III–IV]). Generalized logit models were used to evaluate the association between avulsion and prolapse type and stage. Results The LUG was substantially larger in women with multicompartment compared to single‐compartment POP (28.9 ± 4.1 mm versus 22.7 ± 4.1 mm, P 
ISSN:0278-4297
1550-9613
DOI:10.1002/jum.14644