ArticleInternational urogynecology journal2022
Changes in cardinal ligament length and curvature with parity and prolapse and their relation to level III hiatus measures.
Article in International urogynecology journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 9 citations in OpenAlex.
- Assessing Postpartum Levator Ani Muscle Recovery: A Feasibility Study on Automated Texture Analysis in Transvaginal Ultrasound.Ultrasound in medicine & biology · 2025Article
- Hiatus and pelvic floor failure patterns in pelvic organ prolapse: a 3D MRI study of structural interactions using a level III conceptual model.American journal of obstetrics and gynecology · 2025Article
- Are the uterosacral ligaments detached in young women with pelvic floor symptoms after birth?Acta obstetricia et gynecologica Scandinavica · 2025Article
- Assessment of pelvic organ prolapse with the Pelvic Inclination Correction System: defining the normal range and threshold to pathology.Abdominal radiology (New York) · 2024Article
- Assessment of daily variation in pelvic anatomy in women with and without pelvic organ prolapse.International urogynecology journal · 2023Article
- Hiatal failure: effects of pregnancy, delivery, and pelvic floor disorders on level III factors.International urogynecology journal · 2023Review
- Pelvic inclination correction system for magnetic resonance imaging analysis of pelvic organ prolapse in upright position.International urogynecology journal · 2022Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
introduction and hypothesisTest the hypotheses that (1) cardinal ligament (CL) straightening and lengthening occur with parity and prolapse, (2) CL straightening occurs before lengthening, and (3) CL length is correlated with level III measures.
methodsWe performed a secondary analysis of MRIs from women in three groups: (1) nulliparous with normal support, (2) parous with normal support, and (3) uterine prolapse (POP-Q point C > - 4 and Ba > 1 cm). The 3D stress MRI images at rest and maximal Valsalva were analyzed. CLs were traced from their origin to cervico-vaginal insertions. Curvature ratio was calculated as curved length/straight length. Level III measures included urogenital hiatus (UGH), levator hiatus (LH), and levator bowl volume (LBV), and their correlations with CL length were calculated.
resultsTen women were included in each group. Compared to the nulliparous group, CL length was 18% longer in parous controls (p = .04) and 59% longer with prolapse (p < .01) at rest, while at Valsalva, CL length was 10% longer in parous controls (p = .21) and 49% longer with prolapse (p < .01). Curvature ratios showed 18% more straightening in women with prolapse compared to parous controls (p < .01). Curved CL length and level III measures were moderately to strongly correlated: UGH (rest: R = 0.68, p < .01; Valsalva: R =0.80, p < .01), LH (rest: R = 0.60, p < .01; Valsalva: R = 0.78, p < .01), and LBV (rest: R = 0.71, p < .01; Valsalva: R =0.89, p < .01).
conclusionOur findings suggest that the CLs undergo three times as much lengthening with prolapse as with parity; however, straightening only occurs with prolapse. Strong correlations exist between level I and level III support.
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