Prospective evaluation of change in levator hiatus dimensions using 3D endovaginal ultrasound before and 1 year after treatment for female pelvic organ prolapse.
OBJECTIVE
We aimed to determine the change in levator hiatal (LH) dimensions using 3D high-frequency endovaginal ultrasound (EVUS) before and 1 year after treatment for pelvic organ prolapse (POP).


METHODS
Women with prolapse attending the urogynecology clinic between July and October 2009 were recruited. EVUS was performed using multifrequency (9-16 MHz) 360° rotational probe with a built-in 3D automatic acquisition system (Type 2052, ProFocus Ultra view, B-K Medical, Herlev, Denmark). The levator hiatal dimensions that were measured comprised anteroposterior (AP), left-to-right width, and area. Patients were followed up at 1 year, when EVUS was repeated.


RESULTS
Eighty-nine women had symptomatic prolapse. Of these, 43 opted for surgery and 46 for nonsurgical treatment. Levator hiatal dimensions decreased in AP, width, and area at 12 months after surgery compared with baseline (p <0.05). However, there was no change in any of the dimensions after nonsurgical treatment.


CONCLUSIONS
In contrast to conservative management, there is a significant decrease in levator hiatal dimensions 12 months following surgery for POP.
Department of Obstetrics and Gynecology, Croydon University Hospital, 530 London Road, Croydon, CR7 7YE, Surrey, UK.
Farah
F
Lone
Ranee
R
Thakar
Abdul H
AH
Sultan
Alexandra
A
Stankiewicz
D000328:Adult; D000368:Aged; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000000981:diagnostic imaging* / Q000601:surgery; D056887:Pelvic Organ Prolapse / Q000628:therapy*; D010570:Pessaries; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome