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Interrater reliability of assessing levator ani deficiency with 360° 3D endovaginal ultrasound

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An Erratum to this article was published on 05 February 2014

Abstract

Introduction and hypothesis

Three-dimensional endovaginal ultrasound has been used for evaluation of levator ani muscle deficiency. The aim of this study was to assess interrater agreement/reliability of 3D endovaginal ultrasound for scoring levator ani deficiency (LAD).

Methods

This was a cross-sectional study. Women referred to our urogynecology clinic for different pelvic floor dysfunction symptoms during November 2010–November 2012 were recruited. All patients underwent physical examination, including Pelvic Organ Prolapse Quantification (POP-Q) examination and high-resolution 3D endovaginal ultrasound. The levator muscle was divided into three subgroups based on our prior work: the puboperinealis/puboanalis (PA), puborectalis (PR), and iliococcygeus/pubococcygeus (PV). Subgroups were evaluated in their specific axial plane and were scored according to thickness and detachment from the pubic bone. Scoring was conducted by four raters blinded to case status and to one another’s scores.

Results

Ninety patients were recruited. The median age was 52 (range 24–86). Median body mass index (BMI) was 28.08 (range 17.08–51.39). Fifty percent of patients were menopausal. The range of exact agreement for total LAD score was 77–90 %. All the correlation coefficients at the individual sites as well as the overall scores were positive at above 0.63 and significant at <0.0001 level.

Conclusions

Our study demonstrates excellent agreement between raters assessing levator ani muscle deficiency using 3D endovaginal ultrasound. This level of concordance supports the validity of 3D endovaginal ultrasound technique and scoring method.

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Abbreviations

EVUS:

Endovaginal ultrasound

LAD:

Levator ani deficiency

MRI:

Magnetic resonance imaging

TPUS:

Transperineal ultrasound

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    G. Rostaminia, J. Manonai, E. Leclaire, F. Omoumi, M. Marchiorlatti, L. H. Quiroz & S. A. Shobeiri

  2. Department of Obstetrics and Gynecology, Section of Female Pelvic Medicine & Reconstructive Surgery, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Boulevard, P.O. Box 26901, WP2410, Oklahoma City, OK, 73190, USA

    S. A. Shobeiri

Authors
  1. G. Rostaminia
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  2. J. Manonai
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  3. E. Leclaire
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  4. F. Omoumi
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  5. M. Marchiorlatti
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  6. L. H. Quiroz
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  7. S. A. Shobeiri
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Corresponding author

Correspondence to S. A. Shobeiri.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s00192-014-2336-7.

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Rostaminia, G., Manonai, J., Leclaire, E. et al. Interrater reliability of assessing levator ani deficiency with 360° 3D endovaginal ultrasound. Int Urogynecol J 25, 761–766 (2014). https://doi.org/10.1007/s00192-013-2286-5

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  • DOI: https://doi.org/10.1007/s00192-013-2286-5

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