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Cited by 131Pelvic floor disorders treatmentsUterine Myomas and TreatmentsHernia repair and management

Levator contraction strength and genital hiatus as risk factors for recurrent pelvic organ prolapse

Vakili, Babak, Zheng, Yong T., Loesch, Holly, Echols, Karolynn T., Franco, Nicholas, Chesson, Ralph R.·2005·American Journal of Obstetrics and Gynecology
DOI 10.1016/j.ajog.2004.11.022
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Abstract

Objective To correlate levator ani contraction strength and genital hiatus measurements with surgical failure in prolapse.Study design This retrospective study involved chart review for documentation of levator contraction strength, genital hiatus measurement, and recurrent pelvic floor disorders in women who underwent surgery for prolapse.Results The recurrent prolapse rate was 34.6%. Median follow-up interval was 5 months. Diminished levator strength was associated with recurrent prolapse (35.8% versus 0%; P = .017). A genital hiatus 5 cm or greater was associated with recurrent prolapse (44.2% vs 27.8%; P = .034). Inability to contract the levator ani was associated with urinary incontinence (35.1% vs 18.8%; P = .023). Increasing levator contraction strength was associated with a decreased reoperation rate for pelvic floor disorders, whereas genital hiatus correlated best with recurrent prolapse.Conclusion Diminished levator ani contraction strength and a widened genital hiatus correlate with an increase in surgical failures in the early postoperative period. These tools are useful for counseling a patient concerning surgery for prolapse.

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  • The higher recurrence rate reported by Vakili et al. (58% at 1 year) may be due to differences in the definitions of recurrence used.

    “However, another study by Vakili et al. [16] reported a higher recurrence rate of 58% at 1 year after surgery. This contrast could be due to differences in the definitions of recurrence used. Vakili et al. [16] defined recurrence as any prolapse beyond stage zero according to the POP-Q system, whereas in this study we used POP-Q stage II or greater to define recurrence, as in other studies [12, 13”

    From Risk factors for recurrence of pelvic organ prolapse after vaginal surgery among Ugandan women: a prospective cohort study (2022) · cites this paper as [16]

  • Factors previously found to influence recurrence include age <60 years, postmenopausal status, advanced stages of POP (III-IV), history of complicated delivery, urinary incontinence before POP surgery, widened genital hiatus, high BMI, and failure to perform apical suspension.

    “Several factors have been found to influence recurrence of POP; among them, age < 60 years, postmenopausal status, advanced stages of POP (III–IV), history of complicated delivery, urinary incontinence before POP surgery, widened genital hiatus, high body mass index (BMI), and failure to perform apical suspension [12, 13, 16, 17].”

    From Risk factors for recurrence of pelvic organ prolapse after vaginal surgery among Ugandan women: a prospective cohort study (2022) · cites this paper as [16]

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Authors
Vakili, B., Zheng, Y. T., Loesch, H., Echols, K. T., Franco, N., & Chesson, R. R.
Affiliations
Louisiana State University Health Sciences Center New Orleans (US)
Corresponding author
Vakili, Babak
ORCID
Echols, Karolynn T.
Venue
American Journal of Obstetrics and Gynecology
Publisher
Elsevier BV
Published
2005-05
Volume
192
Issue
5
Pages
1592-1598
ISSN
0002-9378 (ISSN-L)
DOI
10.1016/j.ajog.2004.11.022
OpenAlex
W2078779046
Cited by
131
References
15
Citations by year
2026: 3 · 2025: 3 · 2024: 5 · 2023: 3 · 2022: 8 · 2021: 8 · 2020: 5 · 2019: 6 · 2018: 12 · 2017: 5 · 2016: 6 · 2015: 4 · 2014: 10 · 2013: 9 · 2012: 11
FWCI
3.05
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • American Journal of Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
  • Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
  • Health Sciences › Medicine › Surgery › Hernia repair and management
Keywords
pelvic organ prolapse, prolapse recurrence, genital hiatus, pelvic floor dysfunction, surgical failure, urinary incontinence, reoperation, risk factors
MeSH terms
Adult, Aging, Female, Follow-Up Studies, Genital Diseases, Female, Humans, Middle Aged, Muscle Contraction, Muscular Diseases, Recurrence, Reoperation, Retrospective Studies, Risk Factors, Urinary Incontinence, Uterine Prolapse, Incidence, Pelvic Floor

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