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Three‐dimensional endovaginal ultrasound assessment using the levator ani deficiency score in primiparas: A replication study

INTRODUCTION: It is essential to assess the levator ani properly as part of clinical care in patients presenting with pelvic floor dysfunction. The levator ani deficiency scoring system is a previously published method to assess levator ani defects with three‐dimensional endovaginal ultrasound. The...

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Autores principales: Rotstein, Emilia, Ullemar, Vilhelmina, Starck, Marianne, Tegerstedt, Gunilla
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407012/
https://www.ncbi.nlm.nih.gov/pubmed/37475151
http://dx.doi.org/10.1111/aogs.14633
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author Rotstein, Emilia
Ullemar, Vilhelmina
Starck, Marianne
Tegerstedt, Gunilla
author_facet Rotstein, Emilia
Ullemar, Vilhelmina
Starck, Marianne
Tegerstedt, Gunilla
author_sort Rotstein, Emilia
collection PubMed
description INTRODUCTION: It is essential to assess the levator ani properly as part of clinical care in patients presenting with pelvic floor dysfunction. The levator ani deficiency scoring system is a previously published method to assess levator ani defects with three‐dimensional endovaginal ultrasound. The primary aim of this study was to determine the intra‐ and interrater reliability of the levator ani deficiency score in a cohort of non‐instrumentally delivered primiparas. MATERIAL AND METHODS: Primiparas (n = 141) were examined at least 1 year after vaginal birth. Three‐dimensional endovaginal ultrasound volumes were acquired by a single examiner using two different automated ultrasound probes. The volumes were analyzed by two separate raters who were blinded to each other's assessments. Descriptive statistics were calculated for levator ani deficiency score and categorized into three levels (mild, moderate, severe). Kendall's tau‐b was calculated for intra‐ and interrater comparisons. RESULTS: Intrarater comparisons of levator ani deficiency score and levator ani deficiency category were high (Kendall's tau‐b ≥0.80 for Rater 1; >0.79 for Rater 2). Interrater comparisons of levator ani deficiency score and levator ani deficiency category were also high (Kendall's tau‐b >0.9 for assessment 1 and >0.78 for assessment 2). Varying by rater, probe and assessment, 75.9%–80.1% of the study population had no/mild deficiency, 6.4%–9.2% had moderate deficiency, and 4.3%–6.4% had severe levator ani deficiency. CONCLUSIONS: The levator ani deficiency scoring system is a feasible method to assess defects of the levator ani muscle and can be reproduced with high intra‐ and interrater correlations. Using the scoring system in clinical practice may facilitate concordant assessment between different examiners. However, the system should be used to support clinical findings and symptomatology and not as a screening tool, as the score is lacking the category of no levator ani deficiency.
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spelling pubmed-104070122023-08-09 Three‐dimensional endovaginal ultrasound assessment using the levator ani deficiency score in primiparas: A replication study Rotstein, Emilia Ullemar, Vilhelmina Starck, Marianne Tegerstedt, Gunilla Acta Obstet Gynecol Scand Uro Gynecology INTRODUCTION: It is essential to assess the levator ani properly as part of clinical care in patients presenting with pelvic floor dysfunction. The levator ani deficiency scoring system is a previously published method to assess levator ani defects with three‐dimensional endovaginal ultrasound. The primary aim of this study was to determine the intra‐ and interrater reliability of the levator ani deficiency score in a cohort of non‐instrumentally delivered primiparas. MATERIAL AND METHODS: Primiparas (n = 141) were examined at least 1 year after vaginal birth. Three‐dimensional endovaginal ultrasound volumes were acquired by a single examiner using two different automated ultrasound probes. The volumes were analyzed by two separate raters who were blinded to each other's assessments. Descriptive statistics were calculated for levator ani deficiency score and categorized into three levels (mild, moderate, severe). Kendall's tau‐b was calculated for intra‐ and interrater comparisons. RESULTS: Intrarater comparisons of levator ani deficiency score and levator ani deficiency category were high (Kendall's tau‐b ≥0.80 for Rater 1; >0.79 for Rater 2). Interrater comparisons of levator ani deficiency score and levator ani deficiency category were also high (Kendall's tau‐b >0.9 for assessment 1 and >0.78 for assessment 2). Varying by rater, probe and assessment, 75.9%–80.1% of the study population had no/mild deficiency, 6.4%–9.2% had moderate deficiency, and 4.3%–6.4% had severe levator ani deficiency. CONCLUSIONS: The levator ani deficiency scoring system is a feasible method to assess defects of the levator ani muscle and can be reproduced with high intra‐ and interrater correlations. Using the scoring system in clinical practice may facilitate concordant assessment between different examiners. However, the system should be used to support clinical findings and symptomatology and not as a screening tool, as the score is lacking the category of no levator ani deficiency. John Wiley and Sons Inc. 2023-07-20 /pmc/articles/PMC10407012/ /pubmed/37475151 http://dx.doi.org/10.1111/aogs.14633 Text en © 2023 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Uro Gynecology
Rotstein, Emilia
Ullemar, Vilhelmina
Starck, Marianne
Tegerstedt, Gunilla
Three‐dimensional endovaginal ultrasound assessment using the levator ani deficiency score in primiparas: A replication study
title Three‐dimensional endovaginal ultrasound assessment using the levator ani deficiency score in primiparas: A replication study
title_full Three‐dimensional endovaginal ultrasound assessment using the levator ani deficiency score in primiparas: A replication study
title_fullStr Three‐dimensional endovaginal ultrasound assessment using the levator ani deficiency score in primiparas: A replication study
title_full_unstemmed Three‐dimensional endovaginal ultrasound assessment using the levator ani deficiency score in primiparas: A replication study
title_short Three‐dimensional endovaginal ultrasound assessment using the levator ani deficiency score in primiparas: A replication study
title_sort three‐dimensional endovaginal ultrasound assessment using the levator ani deficiency score in primiparas: a replication study
topic Uro Gynecology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407012/
https://www.ncbi.nlm.nih.gov/pubmed/37475151
http://dx.doi.org/10.1111/aogs.14633
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