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Morphometry of the nulliparous pelvic floor
Author(s) -
NesbittHawes E. M.,
Dietz H. P.,
Abbott J. A.
Publication year - 2018
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.19075
Subject(s) - medicine , pelvic floor , valsalva maneuver , pelvic floor dysfunction , body mass index , pelvic pain , ultrasound , population , gynecology , prospective cohort study , obstetrics , surgery , radiology , blood pressure , environmental health
Objectives To describe morphometry of the pelvic floor in a large population of nulliparous women, comparing those with and those without pelvic pain. We also aimed to assess its association with characteristics such as age and body mass index (BMI). Methods This was a prospective study performed between January 2013 and November 2015 in non‐pregnant nulliparous women attending a general gynecology clinic. Following collection of demographic data, women were examined using translabial four‐dimensional (4D) ultrasound. Dynamic volumes of pelvic floor muscle were obtained at rest, on maximal contraction and on Valsalva maneuver, and analyzed at a later date by an assessor blinded to demographic details. Standard measurements for each volume included levator hiatal area and anteroposterior and transverse diameters, and pubovisceral muscle length and width. Subanalysis was performed comparing women with and those without pelvic pain. Linear regression analysis was performed to assess the association between characteristics, including age and BMI, and levator hiatal area at rest. Results Three hundred and sixty eight nulliparous women were examined using translabial 4D ultrasound. Median levator hiatal area was 10.62 cm 2 at rest, 11.95 cm 2 on Valsalva maneuver and 8.18 cm 2 on maximal contraction. There was no difference between women with and those without pelvic pain when comparing biometric measurements of the pelvic floor musculature, except for in pubovisceral muscle width during the contraction phase. Regression analysis demonstrated that higher age and BMI were associated with increased levator hiatal area measurement. Conclusions Pelvic floor morphometry in nulliparous women is unchanged by pelvic pain, but levator hiatal area is increased in women with higher BMI and age. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.