Academic Journal
Is the Presence of Levator Ani Muscle Avulsion Relevant for the Diagnosis of Uterine Prolapse?
| العنوان: | Is the Presence of Levator Ani Muscle Avulsion Relevant for the Diagnosis of Uterine Prolapse? |
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| المؤلفون: | García-Mejido, José Antonio, Martín-Martinez, Alicia, García-Jimenez, Rocío, González-Diaz, Enrique, Núñez-Matas, María José, Fernández Palacín, Fernando, Carballo-Rastrilla, Sonia, Fernández-Fernández, Camino, Sainz Bueno, José Antonio |
| المساهمون: | Estadística e Investigación Operativa |
| المصدر: | Journal of Ultrasound in Medicine - 2024, Vol. 43, n.2 pp. 265-272 |
| بيانات النشر: | John Wiley and Sons Ltd |
| سنة النشر: | 2024 |
| المجموعة: | RODIN - Repositorio de Objetos de Docencia e Investigación de la Universidad de Cádiz |
| مصطلحات موضوعية: | 3D transperineal ultrasound, pelvic floor, pelvic organ prolapse, uterine prolapse |
| الوصف: | Objective: To determine if the addition of the assessment of levator ani muscle (LAM) avulsion to the measurement of the difference in the pubis-uterine fundus distance between rest and with the Valsalva maneuver could increase the diagnostic capacity of ultrasound for uterine prolapse (UP). Methods: This multicenter, observational and prospective study included 145 patients. Ultrasound assessment was performed, establishing the diagnosis of UP as a difference between the pubic-uterine fundus distance at rest and during the Valsalva maneuver ≥15 mm (standard technique), while LAM avulsion was defined as an abnormal LAM insertion in three central slices using multislice ultrasound. A binary multivariate logistic regression model was made using nonautomated methods to predict surgical UP (general population, premenopausal, and postmenopausal patients), including the difference between the pubis-uterine fundus distance at rest and with the Valsalva maneuver as well as LAM avulsion. Results: A total of 143 patients completed the study. The addition of LAM avulsion criteria to the standard dynamic distance-based protocol for the diagnosis of UP resulted in a higher sensitivity for the general population (79.7 vs 68.1%) as well as for premenopausal (89.3 vs 79.9%) and postmenopausal patients (76 vs 66.1%). In contrast, the standard technique showed a higher specificity than the model based on the standard technique associated with LAM avulsion for the general population (89.2 vs 74.3%) and premenopausal women (91.7 vs 63.2%). For postmenopausal patients, the model based on the standard technique associated with LAM avulsion had a higher sensitivity (76 vs 66.1%) and specificity (91.7 vs 86.8%) than the ultrasound diagnosis of UP. Conclusion: The implementation of the assessment of LAM avulsion in the ultrasound diagnosis of UP is useful in postmenopausal patients, increasing sensitivity and specificity relative to the ultrasound assessment based only on the difference between the pubis-uterine fundus distance at rest ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1550-9613 0278-4297 |
| Relation: | http://hdl.handle.net/10498/32285 |
| DOI: | 10.1002/JUM.16356 |
| الاتاحة: | http://hdl.handle.net/10498/32285 https://doi.org/10.1002/JUM.16356 |
| Rights: | Attribution-NoDerivatives 4.0 Internacional ; http://creativecommons.org/licenses/by-nd/4.0/ ; open access |
| رقم الانضمام: | edsbas.A322026C |
| قاعدة البيانات: | BASE |
| تدمد: | 15509613 02784297 |
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| DOI: | 10.1002/JUM.16356 |