Many women experience symptoms of urinary incontinence, difficulty with bowel function and also symptoms of pelvic organ prolapse. Majority of these women have had children and some may have sustained major pelvic floor muscle trauma during childbirth.
Pelvic floor muscle trauma tends to occur as the baby is delivered vaginally. During delivery, a part of the pelvic floor muscle called the levator muscles can detach from the pubic bone. This is a condition called levator avulsion.
Levator avulsion can be diagnosed clinically; although, it is better visualised with pelvic floor ultrasound. The reality is, women with levator avulsion tend to have weaker pelvic floor muscle function and a higher chance of developing pelvic organ prolapse. These women may also have a lower chance of successful prolapse treatment.
Therefore, it is invaluable to undertake a comprehensive assessment of the pelvic floor when looking after women with pelvic floor symptoms as it can help women better understand their conditions and have a more realistic expectation of treatment outcomes.
It is also useful to have a comprehensive assessment of the pelvic floor in women with urinary or bowel issues as it may shed light to treatment options.
The assessment includes a thorough clinical examination and a pelvic floor ultrasound which will then provide a clearer understanding of the condition and realistic expectations of treatment.
It is imperative that women who have levator avulsion understand that surgery may not offer a long-term successful outcome.