https://doi.org/10.4081/uij.2024.326
The role of levatorplasty procedure in improving genital hiatus area and symptoms in pelvic organ prolapse with ballooning in Indonesia
Submitted: 12 March 2024
Accepted: 31 October 2024
Published: 16 December 2024
Accepted: 31 October 2024
Abstract Views: 0
PDF: 0
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Levatorplasty procedures can be performed in cases of pelvic organ prolapse (POP) with hiatal ballooning to reduce the risk of prolapse recurrence. At Dr. Cipto Mangunkusumo Hospital Jakarta, POP patients with hiatal ballooning during pre-operative ultrasound examination were planned for an additional levatorplasty procedure. However, there was no objective assessment such as the ballooning condition postoperatively. The objective of this paired comparative analytic study was to determine the improvement of ballooning after levatorplasty by assessing anteroposterior (AP) hiatal length and maximal levator hiatal (LHmax) on ultrasound Pelvic Organ Prolapse Quantification System, and the Pelvic Floor Distress Inventory (PFDI) Questionnaire-20. The data of 32 women were taken retrospectively and prospectively during 2021-2022 and statistically analyzed using SPSS 24.0. There was a reduced degree of ballooning measured by LHmax area in 28 patients (87.5%), AP hiatal length in 26 patients (81.25%), and genital hiatus + perineal body length in 25 patients (78.1%) and decreased median value of PFDI to 31.2 (p=0.009) after levatorplasty. The levatorplasty procedure has proven beneficial in improving the objective and subjective outcomes of POP patients with evidence of ballooning on ultrasonography.
Dietz HP, Shek C, Leon JD, Steensma AB. Ballooning of the levator hiatus. Ultrasound Obstet Gynecol 2008;31:676-80.
DOI: https://doi.org/10.1002/uog.5355
Kusuma IGYS, Putra IGM, Megadhana IW, et al. Characteristic of patients with pelvic organ prolaps in obstetric and gynecologic putpatient clinic in Sanglah hospital, Bali, Indonesia from January 2014 to December 2015. Bali Med J 2017;6:76-81.
DOI: https://doi.org/10.15562/bmj.v6i1.390
Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 disease and injuries 1990-2010: a sistematic analysis for the Global Burden of Disease Study. Lancet 2012;380:2163-96.
DOI: https://doi.org/10.1016/S0140-6736(12)61729-2
Santoso BI, Fauziah NR. Prevalence and characteristics of pelvic floor dysfunction in a tertiary care center in Indonesia. INAJOG 2017;5:168-72.
DOI: https://doi.org/10.32771/inajog.v5i3.546
Dietz HP, Franco AVM, Shheck KL, Kirby A. Avulsion injury and levator hiatal ballooning: two independent risk factors for prolapse? An observational study. Acta Obstet Gynecol Scand 2012;91:211-4.
DOI: https://doi.org/10.1111/j.1600-0412.2011.01315.x
Wong V, Shek KL, Korda A, et al. A pilot study on surgical reduction of the levator hiatus-the puborectalis sling. Int Urogynecol J 2019;30:2127-33.
DOI: https://doi.org/10.1007/s00192-019-04062-0
Jallad K, Gurland B. Multidisciplinary approach to the treatment of concomitant rectal and vaginal prolaps. Clin Colon Rectal Surg 2016;29:101-5.
DOI: https://doi.org/10.1055/s-0036-1580721
Silva WA, Karram MM. Rectocele: anatomic and functional repair. In: Textbook of female urology and urogynecology (2nd ed). Cardozo L, Staskin D, eds. London, UK: Informa Healthcare; 2006.
Lamah M, Ho J, Leicester RJ. Results of anterior levatorplasty for rectocele. Colorectal Dis 2001;3:412-6.
DOI: https://doi.org/10.1046/j.1463-1318.2001.00245.x
Liu Z, Tan L. Pelvic floor ultrasound assessment of anterior pelvic organ prolapse recurrence after transvaginal mesh pelvic reconstruction. Ultrasound Obstet Gynecol 2021;58:84.
DOI: https://doi.org/10.1002/uog.23997
Rodrigo N, Shek K, Wong V, Dietz HP. OP13.09: Hiatal ballooning is an independent risk factor of prolapse recurrence. Ultrasound Obstet Gynecol 2012;40:95-6.
DOI: https://doi.org/10.1002/uog.11519
Bø K, Nygaard IE. Is physical activity good or bad for the female pelvic floor? A narrative review. Sports Med 2020;50:471-84.
DOI: https://doi.org/10.1007/s40279-019-01243-1
Nygaard IE, Shaw JM. Physical activity and the pelvic floor. Am J Obstet Gynecol 2016;214:164-71.
DOI: https://doi.org/10.1016/j.ajog.2015.08.067
Takacs P, Kozma B, Larson K. Pelvic organ prolapse: from estrogen to pessary. Menopause 2019;26:121-2.
DOI: https://doi.org/10.1097/GME.0000000000001256
Zhou L, Shangguan AJ, Kujawa SA, et al. Estrogen and pelvic organ prolapse. J Mol Genet Med 2016;10:2.
DOI: https://doi.org/10.4172/1747-0862.1000221
Ismail S, Duckett J, Rizk D, et al. Recurrent pelvic organ prolapse: international urogynecological association research and development committee opinion. Int Urogynecol J 2016;27:1619-32.
DOI: https://doi.org/10.1007/s00192-016-3076-7
Nezhat C, Burns MK, Wood M, et al. Vaginal Cuff Dehiscence and Evisceration. Obstet Gynecol 2018;132: 972-85.
DOI: https://doi.org/10.1097/AOG.0000000000002852
Jakus-Waldman S, Brubaker L, Jelovsek JE, et al. Risk factors for surgical failure and worsening pelvic floor symptoms within 5 years after vaginal prolapse repair. Obstet Gynecol 2020;136:933-41.
DOI: https://doi.org/10.1097/AOG.0000000000004092
How to Cite
Kouwagam, A. D., Moegni, F., Santoso, B. I., Djusad, S., Hakim, S., Priyatini, T., & Meutia, A. P. (2024). The role of levatorplasty procedure in improving genital hiatus area and symptoms in pelvic organ prolapse with ballooning in Indonesia. Urogynaecologia, 36(1). https://doi.org/10.4081/uij.2024.326
Copyright (c) 2024 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
An Open Access Publication is one that meets the following two conditions:
- the author(s) and copyright holder(s) grant(s) to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, transmit and display the work publicly and to make and distribute derivative works, in any digital medium for any responsible purpose, subject to proper attribution of authorship, as well as the right to make small numbers of printed copies for their personal use.
- a complete version of the work and all supplemental materials, including a copy of the permission as stated above, in a suitable standard electronic format is deposited immediately upon initial publication in at least one online repository that is supported by an academic institution, scholarly society, government agency, or other well-established organization that seeks to enable open access, unrestricted distribution, interoperability, and long-term archiving.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
Similar Articles
- Colin Walsh, Wendy Allen, Katrina Parkin, Chinmoy Mukerjee, Kate Moore, Low-count bacteriuria in refractory idiopathic detrusor overactivity versus controls , Urogynaecologia: Vol. 25 No. 1 (2011)
- Pankaj P. Dangle, Lopa K. Pandya IV, Casimir F. Firlit, Bilateral asymptomatic incidental vulvar/labial hemangioma: Kissing Hemangiomas , Urogynaecologia: Vol. 25 No. 1 (2011)
- V. Leanza, F. Genovese, M. Bologna, Laparoscopic application of Mesh in the treatment of pelvic floor disorders: a review of the literature , Urogynaecologia: Vol. 21 No. 1 (2007)
- Samaa Siyam, Ismaiel Abu Mahfouz, Mais Al-Attar, Roaa Khatatbeh, Esraa Qandil, Leen Saifan, Conservative management of a rectovaginal fistula caused by a Gellhorn pessary. A case report , Urogynaecologia: Vol. 36 No. 1 (2024)
- Pau Sarrio-Sanz, Ana Isabel Lopez-Lopez, Laura Martinez-Cayuelas, Luis Gomez-Perez, Manuel Angel Ortiz-Gorraiz, Jesús Romero-Maroto, Is pelvic organ prolapse correction with vaginal mesh suitable with a correct indication and protocolized follow-up? , Urogynaecologia: Vol. 34 No. 1 (2022)
- Stephanie W. Zuo, Jaden R. Kohn, Chi Chiung Grace Chen, Laura Tellechea, Harley Roberts, Ilir Agalliu, Ava Leegant, Nitya Abraham, Melissa Laudano, Assessing frailty in urogynecology patients: a comparative analysis of the Edmonton frail scale and pelvic floor symptom severity , Urogynaecologia: Vol. 35 No. 1 (2023)
- Dorota Borawski, Martin H. Bluth, Wellman W. Cheung, Prevalence of urinary incontinence and other lower tract urinary symptoms in patients with uterine myomas , Urogynaecologia: Vol. 25 No. 1 (2011)
- P. Liguori, R. Ripoli, REPAIR OF POSTERIOR VAGINAL WALL DEFECTS WITH PELVICOL™ IMPLANT ANCHORED TO ILIOCOCCYGEUS , Urogynaecologia: Vol. 20 No. 1 (2006)
- Thibault Thubert, Yohann Dabi, Anne Sophie Boudy, Marion Joubert, Christophe Vaessen, Emmanuel Chartier-Kastler, Jean-Pierre Lefranc, Morgan Rouprêt, Comparison of functional outcomes after robot-assisted laparoscopic sacrocolpopexy in women with a BMI below and above 30 , Urogynaecologia: Vol. 30 No. 1 (2017)
- A. Albiero, A. Gazzoni, S. Giudici, S. Poggi, L. Fedele, EVALUATION OF EFFICACY OF DIFFERENT SURGICAL PROCEDURES IN THE TREATMENT OF SUI AND GENITAL PROLAPSE , Urogynaecologia: Vol. 15 No. 3 (2001)
You may also start an advanced similarity search for this article.