E-Posters-10098

10098_Sardi

Pdf Summary

This study aimed to explore the relationship between forceps delivery and levator ani muscle (LAM) avulsion in patients with lower urinary tract symptoms and/or pelvic floor dysfunction. A retrospective analysis was conducted on 313 patients who underwent transperineal 4D ultrasound (TPUS) at the institution between November 2013 and December 2015. <br /><br />Out of the 313 patients, 48 (15.3%) had a history of forceps delivery, and 18 of them (37.5%) were found to have LAM avulsion. Of the remaining 265 patients who did not have forceps delivery, 47 (17.7%) also had LAM avulsion. The odds ratio for the presence of LAM avulsion in patients with a history of forceps delivery was determined to be 2.78, with a 95% confidence interval of 1.43 to 5.4 and a probability value of 0.0025.<br /><br />The study concluded that a history of forceps delivery was associated with a 3.6 times increased risk of LAM avulsion compared to patients without a history of forceps delivery. This association was assessed using TPUS.<br /><br />In terms of the methodology, all patients underwent TPUS in a supine position, after emptying their bladder and during rest, maximum Valsalva maneuver, and maximal contraction of the pelvic floor. LAM avulsion was diagnosed based on the presence of a clear LAM anomaly at its insertion or a urethra-levator gap greater than 24.9mm in the three central sections at the level of the minimum hiatal dimension.<br /><br />Overall, this study highlights the significance of LAM avulsion as a consequence of forceps delivery and its association with pelvic organ prolapse. TPUS was used as an effective tool for assessing LAM avulsion in this study.

Keywords

forceps delivery

levator ani muscle avulsion

lower urinary tract symptoms

pelvic floor dysfunction

transperineal 4D ultrasound

retrospective analysis

odds ratio

confidence interval

supine position

pelvic organ prolapse