SynthesisArchives of gynecology and obstetrics2023
Management of levator ani avulsion: a systematic review and narrative synthesis.
Synthesis in Archives of gynecology and obstetrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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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
8 citing papers in PubMed, 15 citations in OpenAlex.
- Visual Biofeedback (VB) through Trans-Perineal Ultrasound (TPU) during the active second stage of labor to improve maternal childbirth satisfaction: protocol of a randomized controlled trial.BMC pregnancy and childbirth · 2026Trial
- Disentangling Procedural and Patient-Specific Drivers of Perioperative Outcomes in Pelvic Organ Prolapse Surgery: A Stratified Multigroup Analysis.Healthcare (Basel, Switzerland) · 2026Article
- Women's experiences of life and healthcare after levator ani avulsion: a qualitative interview study.BMC women's health · 2025Article
- Impact of levator ani muscle avulsions on Manchester procedure outcomes: A 5-year follow-up study.Acta obstetricia et gynecologica Scandinavica · 2025Article
- Levator Ani Deficiency and Pelvic Floor Dysfunction 1 Year Postpartum: A Prospective Nested Case-Control Study.BJOG : an international journal of obstetrics and gynaecology · 2025Article
- Subclassification of second-degree tears at delivery: creation and reported outcomes.BMC pregnancy and childbirth · 2025Article
- How to Avoid Becoming a Risk Factor of Fecal Incontinence Due to OASIS-A Narrative Review.Journal of clinical medicine · 2024Review
- Update on Diagnosis and Treatment for Levator Avulsion.Journal of medical ultrasoundReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeLevator ani muscle (LAM) avulsion affects up to 35% of women. Unlike obstetric anal sphincter injury, LAM avulsion is not diagnosed immediately after vaginal delivery, however, has a profound impact on quality of life. The management of pelvic floor disorders is in growing demand yet the significance of LAM avulsion in the context of pelvic floor dysfunction (PFD) is poorly understood. This study collates information on success of treatment for LAM avulsion to establish the best options for management of women.
methodsMEDLINE
resultsNatural healing of LAM avulsion occurs in 50% of women. Conservative measures, including pelvic floor exercises and pessary use are poorly studied. Pelvic floor muscle training for major LAM avulsions was of no benefit. Post-partum pessary use was only of benefit in the first three months for women. Surgeries for LAM avulsion are poorly researched but studies suggest they may provide benefit for 76-97% of patients.
conclusionsWhilst some women with PFD secondary to LAM avulsion improve spontaneously, 50% continue to have pelvic floor symptoms 1 year following delivery. These symptoms result in a significant negative impact on quality of life, however, it is not clear whether conservative or surgical methods are helpful. There is a pressing need for research to find effective treatments and explore appropriate surgical repair techniques for women with LAM avulsion.
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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.