Correlating signs and symptoms with pubovisceral muscle avulsions on magnetic resonance imaging
SourceAmerican Journal of Obstetrics and Gynecology, 208, 2, (2013), pp. 148 e1-7
Article / Letter to editor
Display more detailsDisplay less details
Epidemiology, Biostatistics & HTA
American Journal of Obstetrics and Gynecology
p. 148 e1
SubjectNCEBP 12: Human Reproduction; NCEBP 14: Cardiovascular diseases; NCEBP 2: Evaluation of complex medical interventions; ONCOL 5: Aetiology, screening and detection; NCEBP 12: Human Reproduction; NCEBP 14: Cardiovascular diseases ONCOL 5: Aetiology, screening and detection
OBJECTIVE: We sought to correlate signs and symptoms of pelvic organ prolapse (POP) with pubovisceral muscle avulsions on magnetic resonance imaging (MRI). STUDY DESIGN: In this retrospective cohort study of 189 women with recurrent POP or unexplained symptoms of pelvic floor dysfunction, we reviewed T2-weighted pelvic floor MRI and categorized defects as minor or major avulsion, or as no defect present. Outcomes were correlated to quality-of-life questionnaire scores and data on obstetric and surgical history, together with POP-Quantification (POP-Q) measurements. Multivariable ordinal logistic regression analysis with manual backward elimination was applied to calculate odds ratios (ORs). RESULTS: Major pubovisceral avulsions were diagnosed in 83 (44%) women, minor avulsions in 49 (26%) women, while no defects were seen in 57 (30%) women. Women with a history of episiotomy or anterior vaginal wall reconstructive surgery had a higher OR for more severe pubovisceral muscle avulsions (adjusted OR, 3.77 and 3.29, respectively), as did women with symptoms of POP (OR, 1.01, per unit increase) or higher stage POP of the central vaginal compartment based on POP-Q measurement "C" (OR, 1.18). Women with symptoms of obstructive defecation were more likely to have no defect of the pubovisceral muscle on MRI (OR, 0.97, per unit increase). CONCLUSION: The variables episiotomy, previous anterior vaginal wall reconstructive surgery, POP-Q measurement "C," and symptoms scored with the Urogenital Distress Inventory "genital prolapse" and Defecatory Distress Inventory "obstructive defecation" subscales are correlated with pubovisceral muscle avulsions on pelvic floor MRI.
Upload full text
Use your RU credentials (u/z-number and password) to log in with SURFconext to upload a file for processing by the repository team.