Technique development and measurement of cross-sectional area of the pubovisceral muscle on MRI scans of living women

Masteling, Mariana; Ashton‐Miller, James A.; DeLancey, John O.L.

doi:10.1007/s00192-018-3704-5

Cited by 7 publications

(10 citation statements)

References 24 publications

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“…Within this study, we aimed to measure a precisely defined part of the LAM. This was previously described by the group of DeLancey, who published the measurement of PVM cross-sectional area (CSA) [ 12 ] and showed a good reproducibility. Therefore, we followed this methodology.…”

Section: Introductionmentioning

confidence: 82%

“…The PVM CSA measurements methodology was first published by Masteling et al, who also calculated its confidence intervals for primiparous women after cesarean section [ 12 ]. The cross-sectional area of our nulliparous group (1.09 ± 0.50 cm 2 ) is similar to their range (1.25 ± 0.29 cm 2 ) yet lower.…”

Section: Discussionmentioning

confidence: 99%

“…The PVM CSA was measured as previously described by Masteling et al [ 12 ]. Briefly, the MR images were imported into 3D Slicer, where slices containing the volume of interest were identified in a plane perpendicular to the muscle direction.…”

Section: Methodsmentioning

confidence: 99%

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Comparison of Cross-Sectional Area of Pubovisceral Muscle in Nulliparous and Primiparous Women

Regendova,

Samesova,

Zapletalova

et al. 2024

Int Urogynecol J

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Introduction and Hypothesis The main risk factor for pelvic floor disorders is vaginal delivery, which may cause levator ani muscle (LAM) injury and denervation. LAM includes pubovisceral muscle (PVM, pubococcygeus), puborectalis muscle (PRM), and iliococcygeus muscle. We hypothesize that primiparous women with low pelvic floor muscle contraction have a reduced PVM cross-sectional area (CSA) compared to nulliparous women. Methods (Sample Size and Statistical Approaches) This single-centre prospective observational study compared healthy nulliparous (n = 40) to primiparous (n = 40) women after vaginal delivery without LAM avulsion and Oxford score ≤ 3. Demographics, questionnaires (ICIQ-UI-SF, OAB-Q-SF, PISQ-12), POP-Q, Oxford score, ultrasound measurements (minimal anteroposterior and lateral diameters, hiatal area, PRM thickness, levator-urethra gap) and magnetic resonance imaging (MRI)—PVM CSA were evaluated. Normality was tested, and an appropriate test was used to compare the groups. Power calculation suggested 40 participants per group. Results The primiparous group was older, had a higher BMI, and their hiatal area on ultrasound at contraction was larger compared to the nulliparous group. The CSA of the left-sided PVM (1.15 ± 0.50 cm2) was larger compared to the right side (1.03 ± 0.50 cm2), p = 0.02 in nulliparous women. The PVM CSA of primiparous women with low Oxford score was reduced compared to nulliparous (0.87 ± 0.30 versus 1.09 ± 0.50 cm2, p = 0.006). The intra-rater reliability for PVM CSA had an ICC of 0.90 and inter-rater ICC of 0.77. Conclusions Primiparous women after vaginal delivery with low pelvic floor contraction force had reduced PVM CSA on MRI images compared to nulliparous women.

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Section: Introductionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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Comparison of Cross-Sectional Area of Pubovisceral Muscle in Nulliparous and Primiparous Women

Regendova,

Samesova,

Zapletalova

et al. 2024

Int Urogynecol J

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“…DOI: 10.31550/1727-2378-2019-162-7-46-51 дна, для которой недостаточно физикального обследования любыми методами. Она обязательно должна включать 3D-УЗИ, МРТ или 3D-реконструкцию тазового дна [13][14][15][16][17][18]. Именно недооценка синдрома несостоятельности тазового дна (N81.8.…”

Section: гинекологияunclassified

Current Paradoxes in Perineology

Toktar¹,

Aryutin²,

Volkova³

et al. 2019

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Цель обзора: систематизация контраверсионных аспектов современной перинеологии и пролаптологии. Основные положения. Современная перинеология существует в условиях накопившихся парадоксальных фактов, мнений и решений, среди которых дидактический, эпидемиологический, экономический, анатомический, герниологический, тактический, эволюционный, акушерский, морфологический и другие парадоксы. Существуют два уязвимых места множества исследований, посвященных выпадению тазовых органов у женщин, которые мешают преодолеть упомянутые парадоксы. Первое из них-это представление о тазовом дне как о статичной структуре. Известно, что мышцы тазового дна рефлекторно сокращаются в ответ на любое повышение внутрибрюшного давления аналогично батуту, т. е. никогда не находятся в покое. В то же время внимание исследователей приковано в основном к соединительной ткани тазовых фасций и связок, а основной ткани, обеспечивающей функцию тазового дна-мышечной,-посвящены лишь единичные публикации. Второе уязвимое место современных научных работ-рассмотрение пролапса лишь в одной точке его развития, и, к сожалению, эта точка-конечная. Тактика оперировать только выраженный пролапс, не искать пути хирургической профилактики запутала самих исследователей. Очевидно, что следует изучать морфологические, иммуногистохимические и другие ультраструктурные характеристики тканей на этапе продромальной несостоятельности тазового дна, при синдроме широкого влагалища без манифестации пролапса, сопоставляя полученные данные с результатами применения неинвазивных методов диагностики. Заключение. Получив представление о ранних формах, а не только о выраженном пролапсе с уже сформировавшимися декомпенсаторными необратимыми изменениями тканей и анатомических взаимоотношений, можно попытаться обоснованно объяснить патогенез тазовой десценции и разрешить накопившиеся парадоксы перинеологии. Ключевые слова: пролапс тазовых органов, несостоятельность тазового дна, тазовая дисфункция, перинеология, пролаптология.

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“…Although the epidemiological literature reports PFD prevalence and risk factors from large population surveys [ 2 , 3 ], most clinical studies concentrate on the typical male and female anatomy of the pelvic floor and on the pathological features in persons with PFD. A number of clinical studies reported on morphological variation in the pelvic floor that is relevant for the development of PFD [ 10 , 11 ]. In the present study, we aim to extend current knowledge about the 3D architecture of the pelvic floor muscles in males and females, and to assess how normal variation in pelvic floor shape is associated with other biometric characteristics using a geometric morphometric approach.…”

Section: Introductionmentioning

confidence: 99%

The variation in shape and thickness of the pelvic floor musculature in males and females: a geometric-morphometric analysis

et al. 2022

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Introduction and hypothesis In women, the risk of pelvic floor prolapse is known to be associated with age and parity. Different studies suggested that it is also related to pelvic dimensions, e.g. biomechanical modelling showed that a larger pelvic canal results in higher values of displacement, stress and strain in the pelvic floor muscles, which can increase the risk of pelvic floor disorders. To better understand the multiple factors contributing to pelvic floor disorders, we assessed how age, body weight, body height, parity (in women), pelvic canal size and overall muscle development affected pelvic floor geometry. Methods A comprehensive geometric morphometric analysis of variation in pelvic floor muscle shape was conducted based on a dense set of 3D landmarks measured on CT scans in a cohort of 49 deceased men and 52 deceased women. The multivariate association between biological variables (parity, dimensions of the true pelvis, age, body weight, height) and pelvic floor muscle morphology was explored by reduced rank regression in both sexes. Results In women, advanced age, high body weight relative to body height and a large pelvic canal were associated with a deeper pelvic floor. Surprisingly, parity did not have any strong association with overall pelvic floor shape. In men, high body weight was associated with a deep pelvic floor. Age had little effect on male pelvic floor shape, except for the thickness of the ischiocavernosus muscle, which reduced with age. Conclusion These results suggest that age, relative body weight and the size of the pelvic canal contribute to the risk of female pelvic floor disorders via their effect on pelvic floor shape, independently of birth-related factors such as injury and avulsion of pelvic floor muscles.

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Technique development and measurement of cross-sectional area of the pubovisceral muscle on MRI scans of living women

Abstract: It is possible to use MRI to identify the volume of interest with the maximum anatomic cross section of the PVM belly while minimizing the inadvertent inclusion of adjacent PRM or ICM in that measurement.

Cited by 7 publications

References 24 publications

Comparison of Cross-Sectional Area of Pubovisceral Muscle in Nulliparous and Primiparous Women

Comparison of Cross-Sectional Area of Pubovisceral Muscle in Nulliparous and Primiparous Women

Current Paradoxes in Perineology

The variation in shape and thickness of the pelvic floor musculature in males and females: a geometric-morphometric analysis

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