The prevalence of major abnormalities of the levator ani in urogynaecological patients.
OBJECTIVE
While morphological abnormalities of the pubovisceral muscle have been described on magnetic resonance imaging (MRI), their relevance remains unclear. This study was designed to define prevalence and clinical significance of such abnormalities in urogynaecological patients.


METHODS
Prospective observational study.


METHODS
Tertiary urogynaecological clinic.


METHODS
Three hundred and thirty-eight consecutive women referred for urodynamic assessment.


METHODS
Participants underwent a clinical assessment, multichannel urodynamics and imaging with 3D translabial ultrasound. Blinded offline analysis was performed with the software 4D View (GE Kretztechnik, Zipf, Austria).


METHODS
Major morphological abnormalities of the pubovisceral muscle.


RESULTS
Defects of the pubovisceral muscle were found in 15.4% of parous women. They were exclusively anteromedial (uni- or bilateral), only occurred among women who had delivered vaginally and were associated with anterior and central compartment prolapse (all P<0.001). There was no association with symptoms of bladder dysfunction or urodynamic findings.


CONCLUSIONS
Major morphological abnormalities of the pubovisceral muscle are common in parous urogynaecological patients. They are associated with prolapse of the anterior and central compartment, but not with symptoms of bladder dysfunction or urodynamic findings.
Dietz
H P
HP
University of Sydney, Western Clinical School, Penrith, Australia, and Erasmus Medical Centre, Rotterdam, The Netherlands.
Steensma
A B
AB
D001003:Anal Canal / Q000002:abnormalities*; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000002:abnormalities*; D017773:Pelvic Floor / Q000002:abnormalities; D011446:Prospective Studies; D012005:Rectal Prolapse / Q000209:etiology; D001745:Urinary Bladder Diseases / Q000209:etiology* / Q000503:physiopathology; D014549:Urinary Incontinence / Q000209:etiology / Q000503:physiopathology; D014563:Urodynamics / Q000502:physiology