Comparison of pelvic floor morphometry in supine and standing in women with and without pelvic organ prolapse: A cross-sectional exploratory study

Introduction:: Intra-abdominal pressure (IAP) and gravity may both challenge pelvic organ support and contribute to the development or worsening of pelvic organ prolapse (POP). This study aimed to assess whether pelvic floor morphometry differs between supine and standing positions in women with and...

Full description

Saved in:
Bibliographic Details
Main Authors: Lori B. Forner, Marie-Pierre Cyr, Emma M. Beckman, Paul W. Hodges, Michelle D. Smith
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Continence
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2772973724006416
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850248159412879360
author Lori B. Forner
Marie-Pierre Cyr
Emma M. Beckman
Paul W. Hodges
Michelle D. Smith
author_facet Lori B. Forner
Marie-Pierre Cyr
Emma M. Beckman
Paul W. Hodges
Michelle D. Smith
author_sort Lori B. Forner
collection DOAJ
description Introduction:: Intra-abdominal pressure (IAP) and gravity may both challenge pelvic organ support and contribute to the development or worsening of pelvic organ prolapse (POP). This study aimed to assess whether pelvic floor morphometry differs between supine and standing positions in women with and without POP, at rest and with elevated IAP, and to compare the change in measures from the supine to standing position between groups. Methods:: Thirty premenopausal vaginally parous women with (n=15) and without (n=15) POP were included. Transperineal ultrasound was used to assess pelvic floor morphometry (bladder neck [BN], rectal ampulla [RA], levator plate angle [LPA], anorectal angle [ARA], levator anteroposterior distance [LAP], and levator hiatal area [LHA]) in supine and standing, at rest and bearing down. Measures were compared between positions (supine and standing) and groups (women with and without POP). Results:: At rest, BN and RA were lower and LPA was smaller in standing than supine for all participants (all p<0.04), and LHA and LAP distance were greater in standing than supine for women with POP (p<0.001). In standing rest, BN and RA were lower and LHA was greater in women with than without POP (p<0.001). There were no differences between women with and without POP in these measures in supine (all p>0.23). ARA was greater in women with POP than without POP in both positions at rest (p=0.002). During bearing down, BN and RA were lower, ARA and LPA were smaller, and LHA and LAP distance were larger in standing than in supine for all participants (all p<0.023). In bearing down in both positions, BN and RA were lower and ARA and LHA were greater in women with than without POP (all p=0.013). Conclusion:: Our findings indicate lower pelvic floor support in women with POP compared to women without POP that is evident during bearing down in supine, and at rest and during bearing down in standing. These findings underscore the utility of transperineal ultrasound to assess pelvic floor morphometry in standing to guide management of women with POP.
format Article
id doaj-art-6f4616a8dc074f36ad0038c5bfb2ca1c
institution OA Journals
issn 2772-9737
language English
publishDate 2024-12-01
publisher Elsevier
record_format Article
series Continence
spelling doaj-art-6f4616a8dc074f36ad0038c5bfb2ca1c2025-08-20T01:58:46ZengElsevierContinence2772-97372024-12-011210170810.1016/j.cont.2024.101708Comparison of pelvic floor morphometry in supine and standing in women with and without pelvic organ prolapse: A cross-sectional exploratory studyLori B. Forner0Marie-Pierre Cyr1Emma M. Beckman2Paul W. Hodges3Michelle D. Smith4The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane Queensland, AustraliaThe University of Queensland, School of Health and Rehabilitation Sciences, Brisbane Queensland, AustraliaThe University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane Queensland, AustraliaThe University of Queensland, School of Health and Rehabilitation Sciences, Brisbane Queensland, AustraliaThe University of Queensland, School of Health and Rehabilitation Sciences, Brisbane Queensland, Australia; Correspondence to: School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Queensland, 4072, Australia.Introduction:: Intra-abdominal pressure (IAP) and gravity may both challenge pelvic organ support and contribute to the development or worsening of pelvic organ prolapse (POP). This study aimed to assess whether pelvic floor morphometry differs between supine and standing positions in women with and without POP, at rest and with elevated IAP, and to compare the change in measures from the supine to standing position between groups. Methods:: Thirty premenopausal vaginally parous women with (n=15) and without (n=15) POP were included. Transperineal ultrasound was used to assess pelvic floor morphometry (bladder neck [BN], rectal ampulla [RA], levator plate angle [LPA], anorectal angle [ARA], levator anteroposterior distance [LAP], and levator hiatal area [LHA]) in supine and standing, at rest and bearing down. Measures were compared between positions (supine and standing) and groups (women with and without POP). Results:: At rest, BN and RA were lower and LPA was smaller in standing than supine for all participants (all p<0.04), and LHA and LAP distance were greater in standing than supine for women with POP (p<0.001). In standing rest, BN and RA were lower and LHA was greater in women with than without POP (p<0.001). There were no differences between women with and without POP in these measures in supine (all p>0.23). ARA was greater in women with POP than without POP in both positions at rest (p=0.002). During bearing down, BN and RA were lower, ARA and LPA were smaller, and LHA and LAP distance were larger in standing than in supine for all participants (all p<0.023). In bearing down in both positions, BN and RA were lower and ARA and LHA were greater in women with than without POP (all p=0.013). Conclusion:: Our findings indicate lower pelvic floor support in women with POP compared to women without POP that is evident during bearing down in supine, and at rest and during bearing down in standing. These findings underscore the utility of transperineal ultrasound to assess pelvic floor morphometry in standing to guide management of women with POP.http://www.sciencedirect.com/science/article/pii/S2772973724006416MorphometryPelvic floorPelvic organ prolapseStandingSupineUltrasound imaging
spellingShingle Lori B. Forner
Marie-Pierre Cyr
Emma M. Beckman
Paul W. Hodges
Michelle D. Smith
Comparison of pelvic floor morphometry in supine and standing in women with and without pelvic organ prolapse: A cross-sectional exploratory study
Continence
Morphometry
Pelvic floor
Pelvic organ prolapse
Standing
Supine
Ultrasound imaging
title Comparison of pelvic floor morphometry in supine and standing in women with and without pelvic organ prolapse: A cross-sectional exploratory study
title_full Comparison of pelvic floor morphometry in supine and standing in women with and without pelvic organ prolapse: A cross-sectional exploratory study
title_fullStr Comparison of pelvic floor morphometry in supine and standing in women with and without pelvic organ prolapse: A cross-sectional exploratory study
title_full_unstemmed Comparison of pelvic floor morphometry in supine and standing in women with and without pelvic organ prolapse: A cross-sectional exploratory study
title_short Comparison of pelvic floor morphometry in supine and standing in women with and without pelvic organ prolapse: A cross-sectional exploratory study
title_sort comparison of pelvic floor morphometry in supine and standing in women with and without pelvic organ prolapse a cross sectional exploratory study
topic Morphometry
Pelvic floor
Pelvic organ prolapse
Standing
Supine
Ultrasound imaging
url http://www.sciencedirect.com/science/article/pii/S2772973724006416
work_keys_str_mv AT loribforner comparisonofpelvicfloormorphometryinsupineandstandinginwomenwithandwithoutpelvicorganprolapseacrosssectionalexploratorystudy
AT mariepierrecyr comparisonofpelvicfloormorphometryinsupineandstandinginwomenwithandwithoutpelvicorganprolapseacrosssectionalexploratorystudy
AT emmambeckman comparisonofpelvicfloormorphometryinsupineandstandinginwomenwithandwithoutpelvicorganprolapseacrosssectionalexploratorystudy
AT paulwhodges comparisonofpelvicfloormorphometryinsupineandstandinginwomenwithandwithoutpelvicorganprolapseacrosssectionalexploratorystudy
AT michelledsmith comparisonofpelvicfloormorphometryinsupineandstandinginwomenwithandwithoutpelvicorganprolapseacrosssectionalexploratorystudy