Warping of the levator hiatus: How significant is it?

H. P. Dietz, M. Severino, Ixora Kamisan @ Atan, K. L. Shek, R. Guzman Rojas

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: The levator hiatus is the largest potential hernial portal in the human body. Excessive distensibility is associated with female pelvic organ prolapse (POP). Distension occurs not just laterally but also caudally, resulting in perineal descent and hiatal deformation or 'warping'. The aim of this study was to quantify the warping effect in symptomatic women, to validate the depth of the rendered volume used for the 'simplified method' of measuring hiatal dimensions and to determine predictors for the degree of warping. Methods: This was a retrospective study utilizing records of patients referred to a tertiary urogynecological service between November 2012 and March 2013. Patients underwent a standardized interview, clinical assessment using the POP quantification system of the International Continence Society and four-dimensional translabial ultrasound. The craniocaudal difference in the location of minimal distances in mid-sagittal and coronal planes was determined by offline analysis of ultrasound volumes, and provided a numerical measure of warping. We tested potential predictors, such as demographic factors, signs and symptoms of prolapse, levator avulsion and levator distensibility, for an association with warping. Results: Full datasets were available for 190 women. The mean craniocaudal difference in location of minimal distances in mid-sagittal and coronal planes was -1.26mm (range, -6.7 to 4.6mm; P

Original languageEnglish
JournalUltrasound in Obstetrics and Gynecology
DOIs
Publication statusAccepted/In press - 2016

Fingerprint

Pelvic Organ Prolapse
Prolapse
Human Body
Signs and Symptoms
Retrospective Studies
Demography
Interviews
Datasets

Keywords

  • 4D ultrasound
  • Female pelvic organ prolapse
  • Levator hiatus
  • Measurement
  • Translabial ultrasound

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Reproductive Medicine

Cite this

Warping of the levator hiatus : How significant is it? / Dietz, H. P.; Severino, M.; Kamisan @ Atan, Ixora; Shek, K. L.; Guzman Rojas, R.

In: Ultrasound in Obstetrics and Gynecology, 2016.

Research output: Contribution to journalArticle

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