Összesen 1 találat.


001-es BibID:BIBFORM084850
Első szerző:Kozma Bence (szülész-nőgyógyász)
Cím:Association between pelvic organ prolapse types and levator-urethra gap as measured by 3D transperineal ultrasound / Kozma Bence, Larson Kindra, Scott Lauren, Cunningham Tina, Abuhamad Alfred, Póka Róbert, Takacs Péter
Megjegyzések:Introduction: Pelvic organ prolapse (POP) is a common condition affecting many women. During delivery, the components of the levator ani muscle undergo significant distention and stretching leading to muscle damage 10-25% of the time. Injury to the pelvic floor muscles can result in floor dysfunction like POP or stress urinary incontinence. Levator ani defects can be diagnosed clinically by vaginal palpation or using transperineal ultrasound. Previously the standard sonographic diagnosis of levator avulsion required observation of an abnormal insertion of the muscle on tomographic ultrasound imaging (TUI). But most recently the measurement of the levator?urethra gap (LUG) has been described as a quantitative tool in this regard. LUG is the distance between the center of the urethral lumen and insertion of the levator on the inferior pubic ramus, determined bilaterally, in axial slices on transperineal 3D ultrasound. The measurement of LUG is reproducible and an abnormal LUG (?25mm) has been strongly associated with avulsion diagnosed by vaginal palpation. Objectives: To evaluate the association between POP types and LUG as measured by 3D transperineal tomographic ultrasound (TPUS). Methods: A retrospective study was carried out on ninety-eight women with symptomatic POP. 3D TPUS images and Pelvic Organ Prolapse Quantification coordinates were reviewed. Each vaginal compartment was staged for the degree of prolapse, and total number of involved compartments identified. LUG was measured on 3D tomographic ultrasound images as the distance between the center of the urethra and the levator insertion bilaterally. Based upon prior studies, an abnormal LUG?25mm indicated levator avulsion. LUG and presence or absence of unilateral/bilateral avulsions was analyzed with reference to the clinical diagnosis of prolapse [single vs. multi compartment, and mild (stage II) vs. severe (stage III-IV)]. Generalized logit models were used to evaluate the association between avulsion and prolapse type and stage. Results: The LUG was significantly larger in women with multi compartment compared to single compartment POP (28.9?4.1mm vs. 22.7 ?4.1mm, P<0.01). Similarly, LUG was significantly larger in women with severe (stage III-IV) compared to mild POP (stage II) (28.8 ?4.7mm vs. 23.3?4.5mm, P<0.01). Women with severe prolapse were 32 times more likely than women with mild prolapse to have bilateral levator avulsion. Those with POP involving all three vaginal compartments were 76 times more likely than single compartment POP to have bilateral levator avulsions. Conclusions: Bilateral levator ani avulsion as diagnosed by LUG measurements of ?25mm at rest is associated with multi compartment, sever prolapse.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idézhető absztrakt
Megjelenés:International Urogynecology Journal. - 29 : S1 (2018), p. 174. -
További szerzők:Larson, Kindra Scott, Lauren Cunningham, Tina D. Abuhamad, Alfred Póka Róbert (1960-) (szülész-nőgyógyász, klinikai onkológus) Takács Péter (1968-) (szülész-nőgyógyász)
Internet cím:Szerző által megadott URL
Intézményi repozitóriumban (DEA) tárolt változat
Rekordok letöltése1