Ultrasonographic and Doppler velocimetric evaluation of the levator ani muscle in premenopausal women with and without urinary stress incontinence

Oliveira, Emerson; Castro, Rodrigo Aquino; Takano, Cláudia Cristina; Bezerra, Leonardo Robson Pinheiro Sobreira; Sartori, Marair Grácio Ferreira; Lima, Geraldo R. de; Baracat, Edmund Chada; Girão, Manoel Joâo Batista Castello

doi:10.1016/j.ejogrb.2006.04.042

Cited by 13 publications

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“…17 Therefore, this measurement directly reflects hypertrophy, and ultrasound is a valid and reproducible method for this measurement. 7 In this study, we evaluated 58 women with pelvic organ prolapse before and after physiotherapy treatment. Two important factors directly influenced the initial CSA of the levator ani muscle of these women: age and the presence of pelvic floor dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…Our research group previously demonstrated that this examination had good reproducibility and interobserver correlation. 7 After this evaluation, the subjects were stratified into the three groups described above. The women in GI and GII completed three initial training sessions, with different content for each group.…”

Section: Methodsmentioning

confidence: 99%

“…4,5 Three-dimensional ultrasound is the most common type; however, two-dimensional ultrasound may be useful for evaluating the pelvic floor. 6,7 Many randomized controlled trials and systematic reviews have shown that PFM training is effective for treating stress urinary incontinence, with success rates of between 44% and 80% among adult females. 8,9 However, there is little evidence that it can improve pelvic organ prolapse and its symptoms.…”

Section: Introductionmentioning

confidence: 99%

“…3 Oliveira et al demonstrated the validity and interobserver reproducibility of the technique used in the present study. 7 More longitudinal studies with larger samples and longer follow-up are needed to understand the effect of PFM training on pelvic organ prolapse.…”

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Efficacy of pelvic floor muscle training and hypopressive exercises for treating pelvic organ prolapse in women: randomized controlled trial

et al. 2012

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Efficacy of pelvic floor muscle training and hypopressive exercises for treating pelvic organ prolapse in women: randomized controlled trialEficácia do treinamento da musculatura do assoalho pélvico e de exercícios hipopressivos para o tratamento do prolapso de órgãos pélvicos em mulheres: ensaio clínico randomizado. METHODS: Fifty-eight women with stage II pelvic organ prolapse were divided into three groups for physiotherapy: a pelvic floor muscle training group (GI); a hypopressive exercise group (GII); and a control group (GIII). The patients underwent transperineal ultrasonographic evaluation using a transducer of frequency 4-9 MHz. The (CSA) of the levator ani muscle was measured before physiotherapy and after 12 weeks of treatment. RESULTS:The groups were homogeneous regarding age, number of pregnancies, number of vaginal deliveries, body mass index and hormonal status. Statistically significant differences in CSA were found in GI and GII from before to after the treatment (P < 0.001), but not in relation to GIII (P = 0.816). CONCLUSIONS:The CSA of the levator ani muscle increased significantly with physiotherapy among the women with pelvic organ prolapse. Pelvic floor muscle training and hypopressive exercises produced similar improvements in the CSA of the levator ani muscle. CLINICAL TRIAL REGISTRATION NUMBER: NCT01196598reSUMO CONTEXTO E OBJETIVO: Estudos anteriores mostraram que mulheres com disfunção do assoalho pélvico possuem diminuição da área de secção transversal (AST) do músculo levantador do ânus. Uma forma de avaliar os efeitos de um programa de treinamento é mensurar a AST do músculo por ultrassonografia. O objetivo foi avaliar a eficácia do treinamento da musculatura do assoalho pélvico e de exercícios hipopressivos no aumento da AST do músculo levantador do ânus em mulheres com prolapso de órgãos pélvicos. TIPO DE ESTUDO E LOCAL: Estudo prospectivo, randomizado e controlado realizado no Ambulatório de Uroginecologia da Universidade Federal de São Paulo. MÉTODOS: Cinquenta e oito mulheres com prolapso de órgãos pélvicos estádio II foram divididas em três grupos para tratamento fisioterapêutico: (GI) grupo de treinamento dos músculos do assoalho pélvico, (GII) grupo de exercícios hipopressivos e (GIII) grupo controle. As pacientes se submeteram a avaliação ultrassonográfica transperineal com transdutor de frequência 4-9 MHz. Foi mensurada a AST do músculo levantador do ânus antes e após 12 semanas de tratamento fisioterapêutico. RESULTADOS: Os grupos foram homogêneos no que se refere a idade, número de gestações, número de partos vaginais, índice de massa corpórea e estado hormonal. Diferença significante foi observada na AST de GI e GII antes e após o tratamento (P < 0,001) e isso não ocorreu com o GIII (P = 0,816). CONCLUSÕES: A AST do músculo levantador do ânus aumentou significativamente com tratamento fisioterapêutico em mulheres com prolapso de órgãos pélvicos. Treinamento dos músculos do assoalho pélvico e exercícios hipopressivos são semelhantes no que se refere ao aumento da AST do...

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Efficacy of pelvic floor muscle training and hypopressive exercises for treating pelvic organ prolapse in women: randomized controlled trial

et al. 2012

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“…When compared to continent women, women with UI have poorer PFM morphometry and function in terms of muscle thickness, strength, endurance, and coordination. [11][12][13] Reduced PFM strength and endurance have also been demonstrated in women with POP, 14,15 and POP severity appears to increase with increasing PFM dysfunction. 16,17 Weak PFM strength and wide genital hiatus have been linked with poorer POP quantification scores in women with POP/UI both pre-and postoperatively, 18,19 and have been shown to be risk factors for POP reoperation.…”

Section: Introductionmentioning

confidence: 95%

The impact of pelvic organ prolapse and/or continence surgery on pelvic floor muscle function in women: A systematic review

Mastwyk

McClelland

Rosamilia

et al. 2019

Neurourology and Urodynamics

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Aims To systematically review the evidence for the effect of pelvic organ prolapse (POP) and/or continence surgery on pelvic floor muscle (PFM) morphometry and function in women, and to investigate whether a relationship exists between PFM measures and clinician‐reported objective pelvic floor outcomes postoperatively. Methods Six electronic databases were searched until March 2018. Studies were included if they examined the effect of POP and/or continence surgery on the PFM in women, and reported pre‐ and postoperative data. Methodological quality was assessed using a modified Downs and Black checklist. Three meta‐analyses were planned based on postoperative follow‐up time. Results Twenty‐one studies met the inclusion criteria. Varied surgical interventions and 33 different PFM measures were represented. The methodological quality of included studies varied considerably. The 0 to 6 weeks postoperative meta‐analysis showed no statistically significant change in PFM function (SMD = 0.04; 95% confidence interval [CI] = −0.26 to 0.33). This was consistent at 3 and 6 or more months (SMD = 1.13; 0.35 95% CI = −0.34 to 2.60, − 0.42 to 1.12 respectively). None of the included studies investigated the relationship between PFM measures and clinician‐reported objective outcomes postoperatively. Conclusions This review did not show a clear effect of POP and/or continence surgery on PFM morphometry or function in women and was unable to show a relationship with outcomes such as objective prolapse score and urodynamic findings. This could be because surgery does not measurably impact on the PFM or due to the poor quality and heterogeneity of studies. Future well‐designed research is needed to specifically investigate change in the PFM following surgery.

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Can 3D power Doppler identify levator ani vascularization at its pubic insertion?

et al. 2015

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Ultrasonographic and Doppler velocimetric evaluation of the levator ani muscle in premenopausal women with and without urinary stress incontinence

Cited by 13 publications

References 12 publications

Efficacy of pelvic floor muscle training and hypopressive exercises for treating pelvic organ prolapse in women: randomized controlled trial

Efficacy of pelvic floor muscle training and hypopressive exercises for treating pelvic organ prolapse in women: randomized controlled trial

The impact of pelvic organ prolapse and/or continence surgery on pelvic floor muscle function in women: A systematic review

Can 3D power Doppler identify levator ani vascularization at its pubic insertion?

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