Are Pelvic Floor Muscle Thickness and Size of Levator Hiatus Associated With Pelvic Floor Muscle Strength, Endurance and Vaginal Resting Pressure in Women With Pelvic Organ Prolapse Stages I–III? A Cross Sectional 3D Ultrasound Study

Brækken, Ingeborg Hoff; Majida, Memona; Engh, Marie Ellström; Bø, Kari

doi:10.1002/nau.22384

Cited by 51Pelvic floor disorders treatmentsSexual function and dysfunction studiesUrinary Bladder and Prostate Research

Are Pelvic Floor Muscle Thickness and Size of Levator Hiatus Associated With Pelvic Floor Muscle Strength, Endurance and Vaginal Resting Pressure in Women With Pelvic Organ Prolapse Stages I–III? A Cross Sectional 3D Ultrasound Study

Brækken, Ingeborg Hoff, Majida, Memona, Engh, Marie Ellström, Bø, Kari·2014·Neurourology and Urodynamics

DOI 10.1002/nau.22384

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Abstract

Aims: To investigate if pelvic floor muscle (PFM) thickness and area of levator hiatus (LH) are associated with manometry measured PFM function in 109 women with pelvic organ prolapse (POP) stages I–III. Methods: In this cross‐sectional study pubovisceral muscle thickness and LH area were assessed with three‐dimensional transperineal ultrasound at rest and analyzed in the axial plane. PFM function was assessed with manometry and included strength, endurance, and vaginal resting pressure. Relationships were investigated using univariate linear logistic regressions models, Pearson product‐moment correlation coefficient and hierarchical multiple regression. Results: The mean age was 49 (SD 12). There was a significant positive moderate association between muscle thickness and PFM strength (r = 0.49, P < 0.001) and endurance (r = .45, P < 0.001). A moderate negative association was found between LH area and vaginal resting pressure (r = −0.46, P < 0.001), strength (r = −0.41, P < 0.001) and endurance (r = −0.40, P < 0.001). Multivariate analyses included PFM strength, endurance, vaginal resting pressure, age, parity, BMI and socioeconomic status. Muscle thickness was best explained by PFM strength and LH area was best explained by vaginal resting pressure. However, PFM function explained only 20.0% and 26.4% of the variance in muscle thickness and LH area after controlling for age, parity, BMI, and socioeconomic status. Conclusion: There are moderate associations between measurements using ultrasound and manometry in POP women. Thicker muscles and smaller LH were associated with higher strength and endurance. Smaller LH was additionally associated with higher vaginal resting pressure. Ultrasound and manometry measure different aspects of the PFM and cannot be used interchangeably. Neurourol. Urodynam. 33:115–120, 2014. © 2013 Wiley Periodicals, Inc.

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An increased levator hiatus area, measured by ultrasound, is associated with a low vaginal resting pressure, measured with manometry.
“An increased levator hiatus area, measured by ultrasound, is associated with a low vaginal resting pressure, measured with manometry [17]”
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Authors: Brækken, I. H., Majida, M., Engh, M. E., & Bø, K.
Affiliations: Norwegian School of Sport Sciences (NO)
Akershus University Hospital (NO)
University of Oslo (NO)
Corresponding author: Brækken, Ingeborg Hoff
ORCID: Brækken, Ingeborg Hoff
Engh, Marie Ellström
Bø, Kari
Venue: Neurourology and Urodynamics
Publisher: Wiley
Published: 2013-02-26
Volume: 33
Issue: 1
Pages: 115-120
ISSN: 0733-2467 (ISSN-L)
1520-6777
DOI: 10.1002/nau.22384
OpenAlex: W1522329412
Cited by: 51
References: 39
Citations by year: 2026: 1 · 2025: 5 · 2024: 2 · 2023: 2 · 2022: 8 · 2021: 4 · 2020: 6 · 2019: 7 · 2018: 1 · 2017: 3 · 2016: 3 · 2015: 3 · 2014: 4 · 2013: 2
FWCI: 3.28
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Neurourology and Urodynamics (publishedVersion)
PubMed (publishedVersion)
Funders: Norwegian Foundation for Health and Rehabilitation
Norwegian Women's Public Health Association
Topics: Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
Keywords: levator hiatus, pelvic organ prolapse, muscular endurance, manometry, transperineal ultrasound, pelvic floor function
MeSH terms: Adult, Cross-Sectional Studies, Female, Humans, Image Interpretation, Computer-Assisted, Manometry, Middle Aged, Predictive Value of Tests, Pressure, Severity of Illness Index, Ultrasonography, Vagina, Multivariate Analysis, Linear Models, Logistic Models, Pelvic Floor, Imaging, Three-Dimensional, Muscle Strength, Pelvic Organ Prolapse

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Are Pelvic Floor Muscle Thickness and Size of Levator Hiatus Associated With Pelvic Floor Muscle Strength, Endurance and Vaginal Resting Pressure in Women With Pelvic Organ Prolapse Stages I–III? A Cross Sectional 3D Ultrasound Study

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