Levator ani defect status and lower urinary tract symptoms in women with pelvic organ prolapse.
OBJECTIVE
Among women with pelvic organ prolapse, compare rates of lower urinary tract symptoms by levator ani defect (LAD) status.


METHODS
Urinary incontinence and obstructive voiding are analyzed among 151 women with prolapse whose LAD status was determined with magnetic resonance imaging.


RESULTS
Women with major LAD are less likely to experience stress incontinence when "coughing, laughing, or sneezing" (odds ratio (OR) 0.27) and when "twisting, reaching, lifting, or bending over" (OR 0.26) than women with normal muscles. They are less likely to have obstructive symptoms characterized by assuming an "unusual toileting position" or "changing positions...to start or complete urination" (OR 0.27). Women with minor LAD are more likely to experience stress incontinence with exercise (OR 3.1) and urge incontinence (OR 4.0) than those with normal muscles.


CONCLUSIONS
Lower urinary tract symptoms are less common among women with prolapse and major levator ani defects and more common among those with minor defects.
Morgan
Daniel M
DM
Division of Gynecology, Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA. morgand@med.umich.edu
Cardoza
Pamela
P
Guire
Kenneth
K
Fenner
Dee E
DE
DeLancey
John O L
JO
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D017773:Pelvic Floor / Q000473:pathology / Q000503:physiopathology*; D056887:Pelvic Organ Prolapse / Q000150:complications*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014550:Urinary Incontinence, Stress / Q000453:epidemiology*; D053202:Urinary Incontinence, Urge / Q000453:epidemiology*; D014555:Urination Disorders / Q000453:epidemiology*