PREVALENCE OF LEVATOR ANI MUSCLEAVULSION IN WOMEN PRESENTING FOR PELVIC ORGAN PROLAPSE PREVALENCE OFLEVATOR ANI MUSCLE AVULSION IN WOMEN PRESENTING FOR PELVIC ORGANPROLAPSE
C. YU1, S. CHAN 2,R. CHEUNG 3;
1Obstetrics and Gynaecology,Prince of Wales Hosp., Hong Kong, Hong Kong, 2ChineseUniv. of Hong Kong, Shatin, Hong Kong, 3Obstetrics &Gynecology, Prince of Wales Hosp., Hong Kong, Hong Kong.
Introduction: The prevalence oflevator ani muscle avulsion was found in 32-80% in women with pelvicorgan prolapse. This condition is important because it increases therisk of recurrence of prolapse even after a surgical treatment.However, the previous studies on prevalence of LAM avulsion in womenwith pelvic organ prolapse mainly involved Caucasianwomen.
Objective: The aim of this study is to define theprevalence of levator ani muscle (LAM) avulsion in women presentingwith pelvic organ prolapse and to study the impact of LAM avulsion ontheir quality of life in Chinese women.
Methods: Thisprospective observational study is conducted in a tertiaryurogynecology centre. Women who were referred for pelvic organprolapse were recruited for the study. They were asked to completethe Chinese validated Pelvic Floor Distress Inventory (PFDI) andPelvic Floor Impact Questionnaire (PFIQ). Translabial ultrasound scanwas performed to assess the pelvic floor anatomy including thelevator ani muscle intactness. Demographics are alsoanalysed.
Results: A total of 372 women were recruited.Their mean age was 62.4 and 93 (25%) of them had stage III/IVprolapse. Avulsion was found in 136 women (36.6%). 50 (13.4%) of themhad unilateral LAM avulsion and 86 (23.2%) had bilateral LAMavulsion. LAM avulsion was associated with middle compartmentprolapse, but no association with the anterior and posteriorcompartment was found. The PFDI subscale scores were higher for thegroup with LAM avulsion when compared with those without the avulsion(LAM avulsion vs no avulsion: UDI median 54.3 vs 51.0, POPDI 65.8 vs59.2, CRADI 42.9 vs 35.6), although none of them reached statisticalsignificance.
Conclusions: Prevalence of LAM avulsion amongprolapse women in Chinese population is 37%. No significantassociation was found between LAM avulsion and urinary, bowel orprolapse symptoms scores.