title: Levator contraction strength and genital hiatus as risk factors for recurrent pelvic organ prolapse.
abstract: OBJECTIVE
  To correlate levator ani contraction strength and genital hiatus measurements with surgical failure in prolapse.
  
  
  METHODS
  This retrospective study involved chart review for documentation of levator contraction strength, genital hiatus measurement, and recurrent pelvic floor disorders in women who underwent surgery for prolapse.
  
  
  RESULTS
  The recurrent prolapse rate was 34.6%. Median follow-up interval was 5 months. Diminished levator strength was associated with recurrent prolapse (35.8% versus 0%; P = .017). A genital hiatus 5 cm or greater was associated with recurrent prolapse (44.2% vs 27.8%; P = .034). Inability to contract the levator ani was associated with urinary incontinence (35.1% vs 18.8%; P = .023). Increasing levator contraction strength was associated with a decreased reoperation rate for pelvic floor disorders, whereas genital hiatus correlated best with recurrent prolapse.
  
  
  CONCLUSIONS
  Diminished levator ani contraction strength and a widened genital hiatus correlate with an increase in surgical failures in the early postoperative period. These tools are useful for counseling a patient concerning surgery for prolapse.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery, Louisiana State University Health Sciences Center, New Orleans, USA. vakilibabak@hotmail.com
authors.forename: Babak
authors.initials: B
authors.lastname: Vakili
authors.forename: Yong T
authors.initials: YT
authors.lastname: Zheng
authors.forename: Holly
authors.initials: H
authors.lastname: Loesch
authors.forename: Karolynn T
authors.initials: KT
authors.lastname: Echols
authors.forename: Nicholas
authors.initials: N
authors.lastname: Franco
authors.forename: Ralph R
authors.initials: RR
authors.lastname: Chesson
mesh_terms: D000328:Adult; D000375:Aging; D005260:Female; D005500:Follow-Up Studies; D005831:Genital Diseases, Female / Q000150:complications*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009119:Muscle Contraction; D009135:Muscular Diseases / Q000150:complications* / Q000503:physiopathology* / Q000601:surgery; D017773:Pelvic Floor / Q000503:physiopathology*; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D014549:Urinary Incontinence / Q000209:etiology; D014596:Uterine Prolapse / Q000453:epidemiology / Q000209:etiology*