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Size of the urogenital hiatus in the levator ani muscles in normal women and women with pelvic organ prolapse.

Publication ,  Journal Article
Delancey, JO; Hurd, WW
Published in: Obstet Gynecol
March 1998

OBJECTIVE: Compare urogenital hiatus size in normal women and women with pelvic organ prolapse. METHODS: The sagittal and transverse urogenital hiatus diameters were measured and hiatus area calculated in 300 women whose support was scored using a modified Baden system. RESULTS: In women with normal support and without prior surgery, hiatus area was 5.4 cm2 (+/-1.71 standard deviation [SD], n = 197). In women with uncorrected clinical prolapse (grade 2-3), the area of the hiatus was enlarged (9.6 cm2 +/- 3.97, n = 34, P < .05) and became larger with progressive prolapse (grade 0, 5.4 cm2 +/- 1.71, n = 197; grade 1, 7.3 cm2 +/- 1.91, n = 27; grade 2, 8.3 cm2 +/- 2.45, n = 18; grade 3, 11.0 cm2 +/- 4.90, n = 16). When matched for age and parity, prolapse patients had a larger hiatus than normal women. Women with recurrent prolapse had a larger hiatus than cured women (13.3 cm2 +/- 3.86, n = 8 compared with 8.1 cm2 +/- 2.44, n = 16, P < .05) or women with recurrence after one operation (8.9 cm2 +/- 1.77, n = 18, P < .05). Hiatus size in patients surgically cured (8.3 cm2 +/- 2.44, n = 16) did not return to normal (5.4 cm2 +/- 1.71, n = 197, P < .05). Increasing area of the hiatus was correlated with an increase in anterior-posterior diameter (r2 = 0.9, P < .05), was less attributable to increased transverse diameter (r2 = 0.6, P < .05), and was not related to thickness of the perineal body (r2 = 0.0, P > .05). CONCLUSION: Increasing pelvic organ prolapse is associated with increasing urogenital hiatus size; the hiatus is larger after several failed operations than after successful surgery or single failure.

Duke Scholars

Published In

Obstet Gynecol

DOI

ISSN

0029-7844

Publication Date

March 1998

Volume

91

Issue

3

Start / End Page

364 / 368

Location

United States

Related Subject Headings

  • Reference Values
  • Prolapse
  • Perineum
  • Pelvic Floor
  • Obstetrics & Reproductive Medicine
  • Muscles
  • Middle Aged
  • Humans
  • Female
  • Anal Canal
 

Citation

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Delancey, J. O., & Hurd, W. W. (1998). Size of the urogenital hiatus in the levator ani muscles in normal women and women with pelvic organ prolapse. Obstet Gynecol, 91(3), 364–368. https://doi.org/10.1016/s0029-7844(97)00682-0
Delancey, J. O., and W. W. Hurd. “Size of the urogenital hiatus in the levator ani muscles in normal women and women with pelvic organ prolapse.Obstet Gynecol 91, no. 3 (March 1998): 364–68. https://doi.org/10.1016/s0029-7844(97)00682-0.
Delancey, J. O., and W. W. Hurd. “Size of the urogenital hiatus in the levator ani muscles in normal women and women with pelvic organ prolapse.Obstet Gynecol, vol. 91, no. 3, Mar. 1998, pp. 364–68. Pubmed, doi:10.1016/s0029-7844(97)00682-0.
Journal cover image

Published In

Obstet Gynecol

DOI

ISSN

0029-7844

Publication Date

March 1998

Volume

91

Issue

3

Start / End Page

364 / 368

Location

United States

Related Subject Headings

  • Reference Values
  • Prolapse
  • Perineum
  • Pelvic Floor
  • Obstetrics & Reproductive Medicine
  • Muscles
  • Middle Aged
  • Humans
  • Female
  • Anal Canal