E-Posters-10246

10246_Wyman
Pdf Summary
A study was conducted to evaluate if the levator ani muscle laxity, as measured by the levator ani subtended volume (LASV), is correlated to surgical failure in patients undergoing an apical suspension with mesh augmentation (sacrocolpopexy). LASV represents the volume contained by the levator ani muscle on 3D pelvic MRIs. In this study, eLASV, an easily obtained estimate of LASV from 2D pelvic MRIs, was used to calculate the volume.<br /><br />The study included patients who underwent sacrocolpopexy from 2010-2012 and had a pre-operative pelvic MRI at the institution within one year prior to their surgery. Patients were classified as surgical failure based on a composite score one year after the operation. Measurements including PCL, H-line, and M-line from 2D pelvic images were collected from the radiology report. The width of the levator ani hiatus (WLH) was measured from 2D axial images. LASV was estimated using a mathematical equation. A cutoff value of 38.5 for eLASV was used to determine surgical failure.<br /><br />Out of the 38 patients included in the study, three (7.9%) met the definition for surgical failure. Among the three patients with surgical failure, two had eLASV >38.5 and one had eLASV <38.5. However, there was not a significant correlation between eLASV and surgical success/failure. The study did not find a correlation between eLASV and surgical outcomes for mesh augmentation apical procedures.<br /><br />In conclusion, this study did not find a correlation between eLASV and surgical failure in patients undergoing apical suspension with mesh augmentation. This is different from a previous study that demonstrated an increased risk for surgical failure after a native tissue apical repair at an eLASV of 38.5. Further research is needed to understand the role of eLASV in predicting surgical outcomes in different types of pelvic organ prolapse repairs.
Keywords
levator ani muscle laxity
levator ani subtended volume
LASV
surgical failure
apical suspension
mesh augmentation
sacrocolpopexy
eLASV
2D pelvic MRIs
surgical outcomes