Association of Levator Ani Avulsion and Anatomical and Functional Disorders

Abstract

Abstract Objective: The purpose of this study is to investigate relationship between levator avulsion and anatomical & functional disorders in women who had at least one parity. Methods: Women who complained of pelvic organ prolapse, urinary or defecatory dysfunction were recruited this cohort case-control study. Cases (women with levator defect, diagnosed by 3D translabial ultrasound) and controls (women without levator defect) were compared regarding anterior & posterior vaginal wall prolapse, vaginal apex prolapse, stress & urge urinary incontinence, defecatory dysfunction, increase in urogenital hiatus size, perineal body length, and PFDI-20 questionnaire. Results: The mean age, genital hiatus size, perineal body size, number of parities, normal vaginal deliveries, caesarean sections, measures of vaginal anterior and posterior wall prolapse, prolapse stages, paravaginal prolapse and defecatory disorder prevalence were significantly different between two groups. Body mass index, heaviest baby weight, measure of vaginal apex prolapses, urinary stress and urgency incontinence prevalence, and PFDI-20 questionnaire scores weren’t significantly different between two groups. Conclusion: Levator avulsions seem to increase the risk of vaginal anterior and posterior wall prolapse, voiding dysfunction, paravaginal prolapse and defecatory disorders. The higher age, genital hiatus size, number of parities & normal vaginal deliveries may be associated with the risk of avulsions.