Evaluation of isolated urinary stress incontinence according to the type of levator ani muscle lesion using 3/4D transperineal ultrasound 36 months post-partum
Introduction Vaginal delivery can lead to pelvic floor disorders. Many authors have described pelvic floor injuries that can predict future defects such as urinary incontinence and pelvic organ prolapse. We propose the assessment of urinary stress incontinence and its association with levator ani mu...
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| Veröffentlicht in: | International Urogynecology Journal 2017-07, Vol.28 (7), p.1019-1026 |
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| creator | García Mejido, José Antonio Valdivieso Mejias, Pamela Fernández Palacín, Ana Bonomi Barby, María José De la Fuente Vaquero, Paloma Sainz Bueno, José Antonio |
| description | Introduction
Vaginal delivery can lead to pelvic floor disorders. Many authors have described pelvic floor injuries that can predict future defects such as urinary incontinence and pelvic organ prolapse. We propose the assessment of urinary stress incontinence and its association with levator ani muscle (LAM) microtrauma (>20% in the levator hiatus area during Valsalva) and macrotraumas (avulsion) identified by 3/4D transperineal ultrasound (3D-TpUS) 36 months post-partum.
Materials and methods
This was a prospective observational study including 168 nulliparous women. All patients included were nulliparous with singleton gestation in cephalic presentation, at ≥37 weeks and were recruited on the first day after delivery. Thirty-six months after delivery, 3D-TpUS was carried out to identify LAM lesions (macro or micro). Clinical assessment of urinary stress incontinence (USI) was based on the ICIQ-UI-SF test; a simple stress test and urodynamic test were carried out in the same visit.
Results
A total of 105 nulliparous women were studied (51 spontaneous deliveries [SpD] and 54 vacuum-assisted deliveries [VD]). Microtraumas were identified in 35.3% of SpD and 20.4% of VD. Macrotraumas (avulsion) were identified in 9.8% of SpD and 35.2% of VD (
p
= 0.006). No differences were found in USI between study groups or in relation to the identification of LAM defects (19.2% in the no lesion group, 25% in the macrotrauma and 13.8% in the microtrauma groups;
p
= not significant). Nor were significant differences found in the results from the different study groups in the International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF) test (12.7±2.2 in the no lesion group, 12.5±4.2 in the macrotrauma and 13.25±4.8 in the microtrauma groups;
p
= NS).
Conclusion
No difference was observed in USI between patients with and without LAM lesions (microtrauma or macrotrauma) 36 months post-delivery. |
| doi_str_mv | 10.1007/s00192-016-3208-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1842598425</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1842598425</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-81e494728e255ec8086e7dd39775c9d0e774c1a2710395c69e609ed2684b3af53</originalsourceid><addsrcrecordid>eNp1kcFuFSEUhonR2NvqA7gxJG7cjD3AzDAsTVutSRM3uiaUObedZgZGDjTp2_RZfDKZ3GqMiRsIh-_8h_Ax9kbABwGgTwlAGNmA6BslYWjgGduJVqlGgVTP2Q6M0o1qe3nEjonuAKCFDl6yI6kHLY02O_Z4ce_m4vIUA497PlGcXcaRlzQFlx445YREfAo-hjwFDB658z6mcQo3PEeeb5HnhxW37hnvXY6JuzDxpZCfsZZoiy604eq0Pec5uUAr1nx0My9zPVMsYeSq__m41Cm3xNdIuVldymV5xV7s3Uz4-mk_Yd8_XXw7u2yuvn7-cvbxqvFKy9wMAlvTajmg7Dr0Aww96nFURuvOmxFQ69YLJ7UAZTrfG-zB4Cj7ob1Wbt-pE_b-kLum-KMgZbtM5HGeXcBYyIqhlZ3Zloq--we9iyWF-jorjKgiOiWGSokD5VMkSri3a5qW-qdWgN302YM-W_XZTZ-F2vP2KblcLzj-6fjtqwLyAFC9CjeY_hr939RfxuSn4A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1912085318</pqid></control><display><type>article</type><title>Evaluation of isolated urinary stress incontinence according to the type of levator ani muscle lesion using 3/4D transperineal ultrasound 36 months post-partum</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>García Mejido, José Antonio ; Valdivieso Mejias, Pamela ; Fernández Palacín, Ana ; Bonomi Barby, María José ; De la Fuente Vaquero, Paloma ; Sainz Bueno, José Antonio</creator><creatorcontrib>García Mejido, José Antonio ; Valdivieso Mejias, Pamela ; Fernández Palacín, Ana ; Bonomi Barby, María José ; De la Fuente Vaquero, Paloma ; Sainz Bueno, José Antonio</creatorcontrib><description>Introduction
Vaginal delivery can lead to pelvic floor disorders. Many authors have described pelvic floor injuries that can predict future defects such as urinary incontinence and pelvic organ prolapse. We propose the assessment of urinary stress incontinence and its association with levator ani muscle (LAM) microtrauma (>20% in the levator hiatus area during Valsalva) and macrotraumas (avulsion) identified by 3/4D transperineal ultrasound (3D-TpUS) 36 months post-partum.
Materials and methods
This was a prospective observational study including 168 nulliparous women. All patients included were nulliparous with singleton gestation in cephalic presentation, at ≥37 weeks and were recruited on the first day after delivery. Thirty-six months after delivery, 3D-TpUS was carried out to identify LAM lesions (macro or micro). Clinical assessment of urinary stress incontinence (USI) was based on the ICIQ-UI-SF test; a simple stress test and urodynamic test were carried out in the same visit.
Results
A total of 105 nulliparous women were studied (51 spontaneous deliveries [SpD] and 54 vacuum-assisted deliveries [VD]). Microtraumas were identified in 35.3% of SpD and 20.4% of VD. Macrotraumas (avulsion) were identified in 9.8% of SpD and 35.2% of VD (
p
= 0.006). No differences were found in USI between study groups or in relation to the identification of LAM defects (19.2% in the no lesion group, 25% in the macrotrauma and 13.8% in the microtrauma groups;
p
= not significant). Nor were significant differences found in the results from the different study groups in the International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF) test (12.7±2.2 in the no lesion group, 12.5±4.2 in the macrotrauma and 13.25±4.8 in the microtrauma groups;
p
= NS).
Conclusion
No difference was observed in USI between patients with and without LAM lesions (microtrauma or macrotrauma) 36 months post-delivery.</description><identifier>ISSN: 0937-3462</identifier><identifier>EISSN: 1433-3023</identifier><identifier>DOI: 10.1007/s00192-016-3208-0</identifier><identifier>PMID: 27872979</identifier><language>eng</language><publisher>London: Springer London</publisher><subject>Adult ; Delivery, Obstetric - adverse effects ; Female ; Gynecology ; Health risk assessment ; Humans ; Medicine ; Medicine & Public Health ; Original Article ; Pelvic Floor - diagnostic imaging ; Pelvic Floor - injuries ; Pregnancy ; Prospective Studies ; Ultrasonic imaging ; Ultrasonography ; Urinary Incontinence, Stress - diagnostic imaging ; Urinary Incontinence, Stress - etiology ; Urology ; Young Adult</subject><ispartof>International Urogynecology Journal, 2017-07, Vol.28 (7), p.1019-1026</ispartof><rights>The International Urogynecological Association 2016</rights><rights>International Urogynecology Journal is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-81e494728e255ec8086e7dd39775c9d0e774c1a2710395c69e609ed2684b3af53</citedby><cites>FETCH-LOGICAL-c372t-81e494728e255ec8086e7dd39775c9d0e774c1a2710395c69e609ed2684b3af53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00192-016-3208-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00192-016-3208-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27872979$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>García Mejido, José Antonio</creatorcontrib><creatorcontrib>Valdivieso Mejias, Pamela</creatorcontrib><creatorcontrib>Fernández Palacín, Ana</creatorcontrib><creatorcontrib>Bonomi Barby, María José</creatorcontrib><creatorcontrib>De la Fuente Vaquero, Paloma</creatorcontrib><creatorcontrib>Sainz Bueno, José Antonio</creatorcontrib><title>Evaluation of isolated urinary stress incontinence according to the type of levator ani muscle lesion using 3/4D transperineal ultrasound 36 months post-partum</title><title>International Urogynecology Journal</title><addtitle>Int Urogynecol J</addtitle><addtitle>Int Urogynecol J</addtitle><description>Introduction
Vaginal delivery can lead to pelvic floor disorders. Many authors have described pelvic floor injuries that can predict future defects such as urinary incontinence and pelvic organ prolapse. We propose the assessment of urinary stress incontinence and its association with levator ani muscle (LAM) microtrauma (>20% in the levator hiatus area during Valsalva) and macrotraumas (avulsion) identified by 3/4D transperineal ultrasound (3D-TpUS) 36 months post-partum.
Materials and methods
This was a prospective observational study including 168 nulliparous women. All patients included were nulliparous with singleton gestation in cephalic presentation, at ≥37 weeks and were recruited on the first day after delivery. Thirty-six months after delivery, 3D-TpUS was carried out to identify LAM lesions (macro or micro). Clinical assessment of urinary stress incontinence (USI) was based on the ICIQ-UI-SF test; a simple stress test and urodynamic test were carried out in the same visit.
Results
A total of 105 nulliparous women were studied (51 spontaneous deliveries [SpD] and 54 vacuum-assisted deliveries [VD]). Microtraumas were identified in 35.3% of SpD and 20.4% of VD. Macrotraumas (avulsion) were identified in 9.8% of SpD and 35.2% of VD (
p
= 0.006). No differences were found in USI between study groups or in relation to the identification of LAM defects (19.2% in the no lesion group, 25% in the macrotrauma and 13.8% in the microtrauma groups;
p
= not significant). Nor were significant differences found in the results from the different study groups in the International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF) test (12.7±2.2 in the no lesion group, 12.5±4.2 in the macrotrauma and 13.25±4.8 in the microtrauma groups;
p
= NS).
Conclusion
No difference was observed in USI between patients with and without LAM lesions (microtrauma or macrotrauma) 36 months post-delivery.</description><subject>Adult</subject><subject>Delivery, Obstetric - adverse effects</subject><subject>Female</subject><subject>Gynecology</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Pelvic Floor - diagnostic imaging</subject><subject>Pelvic Floor - injuries</subject><subject>Pregnancy</subject><subject>Prospective Studies</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography</subject><subject>Urinary Incontinence, Stress - diagnostic imaging</subject><subject>Urinary Incontinence, Stress - etiology</subject><subject>Urology</subject><subject>Young Adult</subject><issn>0937-3462</issn><issn>1433-3023</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kcFuFSEUhonR2NvqA7gxJG7cjD3AzDAsTVutSRM3uiaUObedZgZGDjTp2_RZfDKZ3GqMiRsIh-_8h_Ax9kbABwGgTwlAGNmA6BslYWjgGduJVqlGgVTP2Q6M0o1qe3nEjonuAKCFDl6yI6kHLY02O_Z4ce_m4vIUA497PlGcXcaRlzQFlx445YREfAo-hjwFDB658z6mcQo3PEeeb5HnhxW37hnvXY6JuzDxpZCfsZZoiy604eq0Pec5uUAr1nx0My9zPVMsYeSq__m41Cm3xNdIuVldymV5xV7s3Uz4-mk_Yd8_XXw7u2yuvn7-cvbxqvFKy9wMAlvTajmg7Dr0Aww96nFURuvOmxFQ69YLJ7UAZTrfG-zB4Cj7ob1Wbt-pE_b-kLum-KMgZbtM5HGeXcBYyIqhlZ3Zloq--we9iyWF-jorjKgiOiWGSokD5VMkSri3a5qW-qdWgN302YM-W_XZTZ-F2vP2KblcLzj-6fjtqwLyAFC9CjeY_hr939RfxuSn4A</recordid><startdate>20170701</startdate><enddate>20170701</enddate><creator>García Mejido, José Antonio</creator><creator>Valdivieso Mejias, Pamela</creator><creator>Fernández Palacín, Ana</creator><creator>Bonomi Barby, María José</creator><creator>De la Fuente Vaquero, Paloma</creator><creator>Sainz Bueno, José Antonio</creator><general>Springer London</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20170701</creationdate><title>Evaluation of isolated urinary stress incontinence according to the type of levator ani muscle lesion using 3/4D transperineal ultrasound 36 months post-partum</title><author>García Mejido, José Antonio ; Valdivieso Mejias, Pamela ; Fernández Palacín, Ana ; Bonomi Barby, María José ; De la Fuente Vaquero, Paloma ; Sainz Bueno, José Antonio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-81e494728e255ec8086e7dd39775c9d0e774c1a2710395c69e609ed2684b3af53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Delivery, Obstetric - adverse effects</topic><topic>Female</topic><topic>Gynecology</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Pelvic Floor - diagnostic imaging</topic><topic>Pelvic Floor - injuries</topic><topic>Pregnancy</topic><topic>Prospective Studies</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography</topic><topic>Urinary Incontinence, Stress - diagnostic imaging</topic><topic>Urinary Incontinence, Stress - etiology</topic><topic>Urology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>García Mejido, José Antonio</creatorcontrib><creatorcontrib>Valdivieso Mejias, Pamela</creatorcontrib><creatorcontrib>Fernández Palacín, Ana</creatorcontrib><creatorcontrib>Bonomi Barby, María José</creatorcontrib><creatorcontrib>De la Fuente Vaquero, Paloma</creatorcontrib><creatorcontrib>Sainz Bueno, José Antonio</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>International Urogynecology Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>García Mejido, José Antonio</au><au>Valdivieso Mejias, Pamela</au><au>Fernández Palacín, Ana</au><au>Bonomi Barby, María José</au><au>De la Fuente Vaquero, Paloma</au><au>Sainz Bueno, José Antonio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of isolated urinary stress incontinence according to the type of levator ani muscle lesion using 3/4D transperineal ultrasound 36 months post-partum</atitle><jtitle>International Urogynecology Journal</jtitle><stitle>Int Urogynecol J</stitle><addtitle>Int Urogynecol J</addtitle><date>2017-07-01</date><risdate>2017</risdate><volume>28</volume><issue>7</issue><spage>1019</spage><epage>1026</epage><pages>1019-1026</pages><issn>0937-3462</issn><eissn>1433-3023</eissn><abstract>Introduction
Vaginal delivery can lead to pelvic floor disorders. Many authors have described pelvic floor injuries that can predict future defects such as urinary incontinence and pelvic organ prolapse. We propose the assessment of urinary stress incontinence and its association with levator ani muscle (LAM) microtrauma (>20% in the levator hiatus area during Valsalva) and macrotraumas (avulsion) identified by 3/4D transperineal ultrasound (3D-TpUS) 36 months post-partum.
Materials and methods
This was a prospective observational study including 168 nulliparous women. All patients included were nulliparous with singleton gestation in cephalic presentation, at ≥37 weeks and were recruited on the first day after delivery. Thirty-six months after delivery, 3D-TpUS was carried out to identify LAM lesions (macro or micro). Clinical assessment of urinary stress incontinence (USI) was based on the ICIQ-UI-SF test; a simple stress test and urodynamic test were carried out in the same visit.
Results
A total of 105 nulliparous women were studied (51 spontaneous deliveries [SpD] and 54 vacuum-assisted deliveries [VD]). Microtraumas were identified in 35.3% of SpD and 20.4% of VD. Macrotraumas (avulsion) were identified in 9.8% of SpD and 35.2% of VD (
p
= 0.006). No differences were found in USI between study groups or in relation to the identification of LAM defects (19.2% in the no lesion group, 25% in the macrotrauma and 13.8% in the microtrauma groups;
p
= not significant). Nor were significant differences found in the results from the different study groups in the International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF) test (12.7±2.2 in the no lesion group, 12.5±4.2 in the macrotrauma and 13.25±4.8 in the microtrauma groups;
p
= NS).
Conclusion
No difference was observed in USI between patients with and without LAM lesions (microtrauma or macrotrauma) 36 months post-delivery.</abstract><cop>London</cop><pub>Springer London</pub><pmid>27872979</pmid><doi>10.1007/s00192-016-3208-0</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | International Urogynecology Journal, 2017-07, Vol.28 (7), p.1019-1026 |
| issn | 0937-3462 1433-3023 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Adult Delivery, Obstetric - adverse effects Female Gynecology Health risk assessment Humans Medicine Medicine & Public Health Original Article Pelvic Floor - diagnostic imaging Pelvic Floor - injuries Pregnancy Prospective Studies Ultrasonic imaging Ultrasonography Urinary Incontinence, Stress - diagnostic imaging Urinary Incontinence, Stress - etiology Urology Young Adult |
| title | Evaluation of isolated urinary stress incontinence according to the type of levator ani muscle lesion using 3/4D transperineal ultrasound 36 months post-partum |
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