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In vivo assessment of the levator ani muscles using shear wave elastography: a feasibility study in women

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Abstract

Introduction and hypothesis

We hypothesized that shear wave elastography (SWE) technology might be useful for assessing the elastic properties of the pelvic floor in women. Our primary objective was to evaluate the feasibility of assessing the levator ani muscles using SWE in women. Our secondary aim was to investigate the changes in their elastic properties from rest to Valsalva maneuver.

Methods

During this prospective feasibility study in nonpregnant female volunteers, we collected data on participant age, body mass index (BMI), parity, and time since the delivery. The levator ani muscles of each participant were assessed using SWE technology at rest and during a Valsalva maneuver by measuring the shear modulus (in kilopascals). We then assessed the changes in the shear modulus at rest and during the Valsalva maneuver using a Wilcoxon test.

Results

Twelve parous women participated in this study. The mean time since the last delivery was 14 months, the mean age was 31 years, and mean BMI was 28 kg.m−2. All the assessments performed at rest were successfully completed, but we encountered two failures during the Valsalva maneuver. The mean shear modulus increased by a factor of more than 2 from rest to the Valsalva maneuver for both the right (16.0 vs 35.4 kPa) and left side (17.1 vs 37.6 kPa).

Conclusions

An assessment of the elastic properties of the levator ani muscles is feasible for nonpregnant women. The reproducibility of the technique and its application in pregnant women and women with pelvic floor disorders must be investigated.

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Acknowledgements

The authors thank Dr Gregory Legrain (Institut de Recherche en Génie Civile et Mécanique, UMR CNRS 6183, Ecole Centrale de Nantes) for his valuable comments.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, La Miletrie University Hospital, 2 rue de la Miletrie CS90577, 86021, Poitiers Cedex, France

    Bertrand Gachon, Fabrice Pierre, Xavier Fritel & David Desseauve

  2. Laboratory “Movement, Interactions, Performance” (EA 4334), Faculty of Sport Sciences, University of Nantes, Nantes, France

    Antoine Nordez

  3. Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand

    Antoine Nordez

  4. Institut PPrime RoBioSS Unit, Poitiers University ENSMA, CNRS UPR 3346, Futuroscope, France

    Laetitia Fradet

  5. INSERM, Center for Research in Epidemiology and Population Health (CESP), U1018, Gender, Sexuality and Health Team, Univ Paris-Sud, UMRS 1018, Orsay, France

    Xavier Fritel

  6. INSERM CIC-P 1402, La Miletrie University Hospital, Poitiers, France

    Xavier Fritel

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  1. Bertrand Gachon
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  2. Antoine Nordez
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  3. Fabrice Pierre
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  4. Laetitia Fradet
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  5. Xavier Fritel
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  6. David Desseauve
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Correspondence to Bertrand Gachon.

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Gachon, B., Nordez, A., Pierre, F. et al. In vivo assessment of the levator ani muscles using shear wave elastography: a feasibility study in women. Int Urogynecol J 30, 1179–1186 (2019). https://doi.org/10.1007/s00192-018-3693-4

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  • DOI: https://doi.org/10.1007/s00192-018-3693-4

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