Premium
Levator avulsion is a risk factor for cystocele recurrence
Author(s) -
Dietz H. P.,
Chantarasorn V.,
Shek K. L.
Publication year - 2010
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.7678
Subject(s) - medicine , avulsion , surgery , physical examination , levator ani , ultrasound , risk factor , pelvic floor , radiology
Objectives To determine whether levator avulsion is a risk factor for recurrence after cystocele repair. Methods This was an audit of women who underwent anterior colporrhaphy at a tertiary hospital between 2002 and 2005, who were followed up by interview, clinical examination and four‐dimensional translabial ultrasound examination 3–6 years later. Results Of 242 patients identified through theater records we were able to contact 171 (71%). Of 83 who agreed to attend, 24 (29%) reported symptoms of recurrent prolapse. There were 33 (40%) recurrent cystoceles (Stage 2 + ), and 34 (41%) had a significant cystocele on ultrasound examination. On pelvic floor tomographic ultrasound examination, a levator avulsion was detected in 29 (35%) patients. The relative risk of recurrence in women with avulsion was 3.9 (95% CI, 2.4–5.8) when ultrasound criteria of recurrent cystocele were used, and 2.9 (95% CI, 1.7–4.5) when using clinical staging. Conclusion Levator avulsion is associated with a relative risk of 3–4 for cystocele recurrence after anterior colporrhaphy. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.