Association between levator ani avulsion and urinary incontinence in women: A systematic review and meta-analysis

C.F.A. Smeets*, T.F.M. Vergeldt, K.J.B. Notten, F.M.J. Martens, S.M.J. van Kuijk

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

2 Citations (Web of Science)

Abstract

Background: Urinary incontinence is a bothersome symptom. Although the relationship between stress urinary incontinence (SUI) and vaginal delivery is established, the pathology underlying SUI after vaginal birth remains to be elucidated.Objectives: To determine whether levator ani muscle avulsion predisposes for SUI in women.Search strategy: Pubmed and Embase were searched for terms and their variations "levator ani muscle avulsion" and "urinary incontinence", from inception until 5 November 2019.Selection criteria: Inclusion criterion: studies describing the relationship between urinary incontinence and levator ani muscle avulsion in women at least 1 year after delivery. Exclusion criterion: studies only analyzing the urethral sphincter or hiatus dimensions.Data collection and analysis: Odds ratios were used and if not available, were calculated as means of data synthesis, adjusted odds ratios if presented by the study, random-effects model to compute a pooled estimate.Results: Seven studies were included, accounting for 2388 women. Comparing women with and without levator ani muscle avulsion, the overall odds ratio for SUI is 0.87 (95% confidence interval 0.56-1.34), and after adjustment for possible confounders was 0.72 (95% confidence interval 0.40-1.30).Conclusion: There is no relationship between levator ani muscle avulsion and SUI in women.
Original languageEnglish
Pages (from-to)25-32
Number of pages8
JournalInternational Journal of Gynecology & Obstetrics
Volume153
Issue number1
DOIs
Publication statusPublished - Apr 2021

Keywords

  • Levator ani muscle avulsion
  • Pathophysiologic urinary incontinence
  • Stress urinary incontinence
  • Urinary incontinence
  • levator ani muscle avulsion
  • pathophysiologic urinary incontinence
  • stress urinary incontinence
  • urinary incontinence
  • PELVIC ORGAN PROLAPSE
  • RISK-FACTORS
  • INJURY
  • SYMPTOMS
  • PREVALENCE
  • DELIVERY
  • MUSCLE AVULSION
  • FLOOR
  • PRIMIPAROUS WOMEN
  • TRAUMA

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