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

Vol. 36 No. 1 (2024)
Published: 16 December 2024
Ballooning, genital hiatus, levatorplasty, pelvic organ prolapse, PFDI-20
Abstract Views: 586
PDF: 137
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.

Authors

Anggrainy Dwifitriana Kouwagam
Reconstructive Esthetic Urogynecology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
Fernandi Moegni
fernandi71@ui.ac.id
https://orcid.org/0000-0001-9537-4256
Reconstructive Esthetic Urogynecology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
Budi Iman Santoso
Reconstructive Esthetic Urogynecology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
Suskhan Djusad
https://orcid.org/0000-0001-9818-7456
Reconstructive Esthetic Urogynecology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
Surahman Hakim
Reconstructive Esthetic Urogynecology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
Tyas Priyatini
Reconstructive Esthetic Urogynecology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
Alfa Putri Meutia
Reconstructive Esthetic Urogynecology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.

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.

Altmetrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
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



The role of levatorplasty procedure in improving genital hiatus area and symptoms in pelvic organ prolapse with ballooning in Indonesia. (2024). Urogynaecologia, 36(1). https://doi.org/10.4081/uij.2024.326
Copyright (c) 2024 the Author(s) Creative Commons License

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.


Similar Articles

61-68 of 68

You may also start an advanced similarity search for this article.