PMID- 35538253
OWN - NLM
STAT- MEDLINE
DCOM- 20220712
LR  - 20221007
IS  - 1433-3023 (Electronic)
IS  - 0937-3462 (Print)
IS  - 0937-3462 (Linking)
VI  - 33
IP  - 7
DP  - 2022 Jul
TI  - Is levator ani avulsion a risk factor for prolapse recurrence? A systematic 
      review and meta-analysis.
PG  - 1813-1826
LID - 10.1007/s00192-022-05217-2 [doi]
AB  - INTRODUCTION AND HYPOTHESIS: Levator ani muscle avulsion as a risk factor for 
      prolapse recurrence is not well established. This systematic review was aimed at 
      evaluating the correlation between levator ani avulsion and postoperative 
      prolapse recurrence with meta-analysis, specifically, the risk of subjective or 
      objective prolapse recurrence and reoperation. METHODS: The protocol was 
      registered in the International Prospective Register of Systematic Reviews 
      (registration number CRD42021256675). A systematic literature search was 
      conducted using PubMed, EMBASE and Cochrane Database of Systematic Reviews to 
      identify all peer-reviewed studies that described levator avulsion in women and 
      investigated operative and postoperative outcomes. All peer-reviewed, 
      English-language cohort studies in those with and without levator avulsion with a 
      minimum of 3 months' follow-up were included. Pooled unadjusted and adjusted odds 
      ratios were calculated for subjective recurrence, objective recurrence and rates 
      of re-operation. The Cochrane Collaboration Risk of Bias In Non-Randomized 
      Studies (RoBINS) and The Grading of Recommendations Assessment, Development and 
      Evaluation (GRADE) tools were used to assess the quality of the studies included. 
      RESULTS: Twelve studies with a total of 2,637 subjects and a follow-up period 
      0.3-6.4 years were identified. There were insufficient data to report a pooled 
      adjusted risk for subjective recurrence and reoperation. On low to moderate 
      quality-adjusted data, the pooled odds of objective recurrence was not 
      significantly associated with levator ani avulsion (aOR 1.68; 95% CI 0.78-3.66). 
      CONCLUSION: Levator ani avulsion has not been confirmed as a risk factor for 
      objective prolapse recurrence. Further evidence is needed to investigate the 
      correlation between levator ani avulsion and the risk of subjective recurrence 
      and reoperation.
CI  - (c) 2022. Crown.
FAU - Yeung, Ellen
AU  - Yeung E
AUID- ORCID: 0000-0002-4245-548X
AD  - Department of Urogynaecology, Women's and Newborn Services, Royal Brisbane and 
      Women's Hospital, Brisbane, Australia. drellenyeung@gmail.com.
AD  - The University of Queensland, Saint Lucia, QLD, Australia. 
      drellenyeung@gmail.com.
FAU - Malacova, Eva
AU  - Malacova E
AD  - Statistics Unit, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
FAU - Maher, Christopher
AU  - Maher C
AD  - Department of Urogynaecology, Women's and Newborn Services, Royal Brisbane and 
      Women's Hospital, Brisbane, Australia.
AD  - The University of Queensland, Saint Lucia, QLD, Australia.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20220510
PL  - England
TA  - Int Urogynecol J
JT  - International urogynecology journal
JID - 101567041
SB  - IM
MH  - Female
MH  - Humans
MH  - Pelvic Floor/diagnostic imaging/surgery
MH  - *Pelvic Organ Prolapse/etiology/surgery
MH  - Reoperation
MH  - Risk Factors
MH  - Ultrasonography/methods
PMC - PMC9270296
OTO - NOTNLM
OT  - Levator ani muscle avulsion
OT  - Pelvic organ prolapse
OT  - Recurrence
OT  - Risk factors
OT  - Surgery
COIS- None.
EDAT- 2022/05/11 06:00
MHDA- 2022/07/14 06:00
PMCR- 2022/05/10
CRDT- 2022/05/10 23:27
PHST- 2022/02/08 00:00 [received]
PHST- 2022/04/06 00:00 [accepted]
PHST- 2022/05/11 06:00 [pubmed]
PHST- 2022/07/14 06:00 [medline]
PHST- 2022/05/10 23:27 [entrez]
PHST- 2022/05/10 00:00 [pmc-release]
AID - 10.1007/s00192-022-05217-2 [pii]
AID - 5217 [pii]
AID - 10.1007/s00192-022-05217-2 [doi]
PST - ppublish
SO  - Int Urogynecol J. 2022 Jul;33(7):1813-1826. doi: 10.1007/s00192-022-05217-2. Epub 
      2022 May 10.