ArticleInternational urogynecology journal2014
Levator ani defect scores and pelvic organ prolapse: is there a threshold effect?
Article in International urogynecology journal, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 38 citations in OpenAlex.
- The FIGO assessment scoring system (FASS): a new holistic classification tool to assess women with pelvic floor dysfunction: validity and reliability.International urogynecology journal · 2015Trial
- Multi-parametric Quantitative MRI to Evaluate the Value of Pelvic Floor Muscle Dysfunction in POP Patients.International urogynecology journal · 2026Article
- Perineal structural changes on 3-dimensional endovaginal ultrasound 6 months after difficult vaginal birth: the Hourglass-Band pattern and how it relates to levator ani avulsion and hiatus size.American journal of obstetrics and gynecology · 2026Article
- Upright and supine assessment of pelvic floor muscle defects in women with and without prolapse.Scientific reports · 2026Article
- Bony birth canal and pelvic organ prolapse: a quantitative assessment for dimensions of pelvic midplanes based on MRI.Abdominal radiology (New York) · 2025Article
- A new understanding of the mechanical mechanism of posterior vaginal prolapse based on magnetic resonance imaging.Nagoya journal of medical science · 2025Article
- Female levator ani muscle damage assessment in supine and upright position.Scientific reports · 2025Article
- Postpartum Changes in Levator Plate Shape and Genital Hiatus Size After Vaginal Delivery.International urogynecology journal · 2024Article
- One-year follow-up after standardized perineal reconstruction in women with deficient perineum after vaginal delivery.Acta obstetricia et gynecologica Scandinavica · 2023Article
- A comparison of MRI-based pelvic floor support measures between young and old women with prolapse.International urogynecology journal · 2023Article
- Appearance of levator ani muscle subdivision defects on level III vaginal support structures in women with and without pelvic organ prolapse: an MRI study.International urogynecology journal · 2023Article
- Multilevel musculo-fascial defect magnetic resonance study of female pelvic floor: retrospective case control study in women with pelvic floor dysfunction after the first vaginal delivery.Acta obstetricia et gynecologica Scandinavica · 2022Article
- Preoperative level II/III MRI measures predicting long-term prolapse recurrence after native tissue repair.International urogynecology journal · 2022Article
- Mechanisms of hiatus failure in prolapse: a multifaceted evaluation.International urogynecology journal · 2021Article
- Determining "abnormal" levator hiatus distensibility using three-dimensional transperineal ultrasound in Chinese women.Frontiers of medicine · 2018Article
- Structural, functional, and symptomatic differences between women with rectocele versus cystocele and normal support.American journal of obstetrics and gynecology · 2018Article
- Combination of tomographic ultrasound imaging and three-dimensional magnetic resonance imaging-based model to diagnose postpartum levator avulsion.Scientific reports · 2017Article
- Paravaginal defect: anatomy, clinical findings, and imaging.International urogynecology journal · 2017Review
- An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction.International urogynecology journal · 2017Article
- Structural Failure Sites in Anterior Vaginal Wall Prolapse: Identification of a Collinear Triad.Obstetrics and gynecology · 2016Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
introduction and hypothesisThe goal of this study was to use a well-described system of quantifying levator ani defect (LAD) severity using magnetic resonance imaging (MRI) to examine the relationship between defect severity and the presence or absence of prolapse.
methodsThis is a secondary analysis of two case-control studies comparing 284 cases (with prolapse) to 219 controls (normal support) defined by using Pelvic Organ Prolapse Quantification (POP-Q) exams. LAD were assessed on MRI, with scores from 0 (no defects) to 6 (complete, bilateral defects). The number of cases and controls at each score were compared. Logistic regression and receiver operating characteristic (ROC) analyses were used to quantify relationships between LAD and prolapse.
resultsThe proportion of cases exceeds the overall prolapse rate in this study at LAD scores ≥3, with higher rates of prolapse at higher LAD scores (p < 0.0000001). Prolapse risk stratifies into low risk at LAD scores 0-2, moderate at 3-5, and high at 6. ROC analysis for classification of prolapse based on LAD scores has an area under the curve of 69.9% (p < 0.001), suggesting LAD alone can discriminate between normal support and prolapse for nearly 70% of patients. Logistic regression identified higher parity and higher LAD scores as independent predictors of prolapse.
conclusionsThere are three clusters of prolapse risk: low (0-2), moderate (3-5), and high (6). Although LAD have a dose-response-like effect for prolapse, other factors are clearly involved.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.