Author:

Keywords:

Fecal incontinence, Levator ani abnormalities, Pelvic floor muscle contraction, Stress urinary incontinence, Prolapse, Transperineal ultrasound, Science & Technology, Life Sciences & Biomedicine, Obstetrics & Gynecology, Urology & Nephrology, ANI MUSCLE DEFECTS, URINARY-INCONTINENCE, PERINEAL ULTRASOUND, WOMEN, STANDARDIZATION, TERMINOLOGY, TRAUMA, Adult, Aged, Aged, 80 and over, Fecal Incontinence, Humans, Middle Aged, Muscle Contraction, Pelvic Floor, Pelvic Organ Prolapse, Prevalence, Retrospective Studies, Ultrasonography, Urinary Incontinence, Stress, Young Adult, 1114 Paediatrics and Reproductive Medicine, Obstetrics & Reproductive Medicine, 3215 Reproductive medicine, 4204 Midwifery

Abstract:

INTRODUCTION AND HYPOTHESIS: Major levator ani abnormalities (LAA) may lead to abnormal pelvic floor muscle contraction (pfmC) and secondarily to stress urinary incontinence (SUI), prolapse, or fecal incontinence (FI). METHODS: A retrospective observational study included 352 symptomatic patients to determine prevalence of LAA in underactive pfmC and the relationship with symptoms. On 2D/3D transperineal ultrasound, PfmC was subjectively assessed as underactive (UpfmC) or normal (NpfmC) and quantified. LAA, defined as a complete avulsion of the pubic bone, was analyzed using tomographic ultrasound imaging. RESULTS: LAA were found in 53.8% of women with UpfmC versus 16.1% in NpfmC (P < / 0.001). Patients with UpfmC were less likely to reduce hiatal area on pfmC (mean 7% reduction vs 25% in NpfmC (P < / 0.001)). An UpfmC was associated with FI (P = 0.002), not with SUI or prolapse of the anterior and central compartment. CONCLUSION: An underactive pfmC is associated with increased prevalence of LAA and FI.