Vaginal prolapse and levator ani avulsion injury

Česká verzia

Authors: K. Švabík; M. Martan; J. Mašata
Authors place of work: Gynekologicko-porodnická klinika, 1. LF UK a VFN, Praha
Published in the journal: Ceska Gynekol 2012; 77(4): 304-307

Summary

Levator ani avulsion injury is one of the main factors associated with vaginal prolapse of all compartments. Levator avulsion is the main link between vaginal delivery and subsequent vaginal prolapse – cause and sequel.

The risk for prolapse is doubled in women with levator injury (RR = 1,9).

The risk for prolapse is mainly expressed for anterior and central compartment.

In retrospective analysis of women after vaginal repair without use of implants the recurrence rate was 29%. In subanalysis of only of women with recurrence the avulsion injury was detected in 85%. The risk of recurrence of prolapse after native tissue repair is four times higher if the avulsion is present to those where not.

Levator avulsion injury is main etiological and risk factor associated with uterine and vaginal prolapse as the sequel of delivery trauma. This injury also increases significantly the risk of prolapse recurrence after native tissue vaginal repair.

Key words:
avulsion injury, levator ani, vaginal prolapse, 4D ultrasound.

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