Changes in levator ani muscle after vaginal hysterectomy and prolapse repair using the Total Prolift procedure

Objective: To assess changes in the levator plate angle (LPA), anteroposterior length of the levator hiatus (H-line), and pelvic floor descent (M-line) after vaginal hysterectomy and prolapse repair using the Gynecare Prolift Total Pelvic Floor Repair System. Methods: Before and after the intervention, 20 women with pelvic floor prolapse underwent dynamic magnetic resonance imaging in supine position during the Valsalva maneuver to measure the LPA, H-line, and M-line. Paired t tests were performed and Pearson correlation coefficients calculated from values obtained using the pelvic organ prolapse quantification system. Results: After the intervention the LPA was smaller (46.92 degrees vs 55.39 degrees, P<0.05), the H-line was shorter (53.70 cm vs 60.46 cm, P<0.05), and the M-line was shorter (19.58 cm vs 25.27 cm, P<0.05). Conclusion: These changes Suggest an efficient reconstruction and reinforcement of the pelvic floor after the Surgery. (C) 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd All rights reserved.