Evidence map›Paper›PMID 42068350›Full record

ArticleInternational urogynecology journal2026

Perineal Membrane Structural Changes: An Unstudied Aspect of Prolapse.

Fernanda Pipitone, Carolyn W Swenson, John O L DeLancey, James A Ashton-Miller, Luyun Chen

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International urogynecology journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Fernanda PipitoneDisciplina de Ginecologia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina, Universidade de Sao Paulo, Av Dr Eneas de Carvalho Aguiar, 255, Sao Paulo, 05403-000, Brazil. fernanda.pipitone@gmail.com.ORCID http://orcid.org/0000-0001-5134-8523
Carolyn W SwensonDepartment of Obstetrics and Gynecology, University of Utah, 324 10Th Ave #200, Salt Lake City, UT, 84103, USA.ORCID http://orcid.org/0009-0008-7717-673X
John O L DeLanceyPelvic Floor Research Group, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA.ORCID http://orcid.org/0000-0002-1012-7713
James A Ashton-MillerPelvic Floor Research Group, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA.ORCID http://orcid.org/0000-0003-1528-2787
Luyun ChenPelvic Floor Research Group, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA.ORCID http://orcid.org/0000-0001-6861-180X

Funding

Research Education CoreP30AG024824 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Neil Alexander · 2004 to 2026
$29.2M
Which pelvic floor defects cause stress incontinence?P50HD044406 · NICHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI DELANCEY, JOHN O.L. · 2002 to 2017
$17.1M
Development of 21st Century Concepts and Tools for Quantifying Urethral Failure Mechanisms that Cause Urinary IncontinenceRC2DK122379 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI ASHTON-MILLER, JAMES ANTHONY, DELANCEY, JOHN O.L. · 2019 to 2024
$5.7M
University of Michigan WRHR Career Development ProgramK12HD065257 · NICHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI FENNER, DEE ELLEN · 2010 to 2019
$3.4M
Using a mechanistic classification scheme to identify the causes of anterior vaginal wall prolapse and develop a validated surgical planning systemR01HD094954 · NICHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CHEN, LUYUN · 2018 to 2020
$935k
National Institute of Child Health and Human Development K12 HD065257National Institute of Child Health and Human Development R01 HD 094954 / P50 HD 044406NIA NIH HHS AG024824NIA NIH HHS P30 AG024824NICHD NIH HHS K12 HD065257NICHD NIH HHS P50 HD044406NICHD NIH HHS R01 HD094954NIDDK NIH HHS RC2 DK122379
6 · The paper itself

Abstract

introduction and hypothesisThe perineal membrane (PM), perineal body, and levator ani muscles form the perineal complex, which is responsible for hiatal closure. Yet failures in its connective tissues that may lead to hiatal closure impairment are poorly understood. We tested the hypothesis that pelvic organ prolapse involves PM abnormalities by comparing PM morphology between young women with prolapse and parous controls using a validated MRI-based reconstruction and analysis technique.

methodsThis is a secondary analysis of MRIs from two prior studies. The PM was traced on coronal scans in 3D Slicer

resultsResting MRIs from 17 young parous women (aged < 40 years) with prolapse and 20 parous controls were compared. Women with prolapse showed 23% greater midline separation of the PM, 30% larger hiatal area, 26% larger hiatal anteroposterior diameter, 17% longer bony origin, and 26% larger PM surface area (all p ≤ 0.002, d = 1.1-1.6); swinging door angle was similar between groups (p = 0.60). Levator ani status, midline separation, and PM surface area independently predicted prolapse, explaining 76% of variance.

conclusionsThe PM structure was altered in those with prolapse through loss of central PM connection, hiatal elongation, and hiatal widening. Larger studies are needed to confirm and guide targeted repair techniques that could potentially prevent prolapse development and/or progression.

Indexed as

Pelvic FloorPelvic Organ ProlapsePerineumAdultCase-Control StudiesFemaleHumansMagnetic Resonance ImagingYoung AdultMagnetic resonance imagingPelvic organ prolapsePerineal membraneUrogenital diaphragmUrogenital hiatus

Identifiers

PMID42068350
PMCPMC13649911

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.