Ultrasonographic and doppler velocimetric evaluation of the levator ani muscle according to the hormonal status

Eur J Obstet Gynecol Reprod Biol. 2008 Dec;141(2):183-5. doi: 10.1016/j.ejogrb.2008.06.008. Epub 2008 Aug 26.

Abstract

Objective: We aimed to study the cross-sectional area of levator ani muscle and the doppler velocimetric parameters of vessels its in premenopausal and postmenopausal women.

Study design: Sixty-four patients, divided into 3 groups, were assessed: group I (20 women-average age 28 years) premenopausal and nulliparous (control); group II (24 women-average age 38 years, vaginal delivery 1-4) premenopausal with vaginal deliveries; group III (20 women-average age 55 years, parity 0-4) postmenopausal without hormonal therapy. Doppler velocimetry of levator ani muscle vessels through resistance and pulsatility indices was used and the means of the groups compared by adjusting the weighed variance model with multiple comparisons, according to Tukey's method. Similarly, we measured the cross-sectional area of the muscle using ultrasonography.

Results: There was a significant increase in resistance and pulsatility indices in postmenopausal patients as compared to the other two groups. We also observed a significant decrease in the cross-sectional area of the muscle of postmenopausal patients when compared to those in premenopausal.

Conclusion: The obtained results allow us to conclude that levator ani muscle vascularization significantly decreases after menopause (age and/or hipoestrogenism) and that it can be assumed that vaginal delivery does not promote long-term alterations in levator ani muscle vascularization. We also observed a significant decrease in the cross-sectional area of the muscle in postmenopausal women when compared to those in premenopausal.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anal Canal / blood supply
  • Anal Canal / diagnostic imaging*
  • Anal Canal / physiology*
  • Delivery, Obstetric
  • Electromyography
  • Female
  • Humans
  • Middle Aged
  • Muscle, Smooth / blood supply
  • Muscle, Smooth / diagnostic imaging*
  • Muscle, Smooth / physiology*
  • Pelvic Floor / diagnostic imaging
  • Postmenopause / physiology*
  • Premenopause / physiology*
  • Ultrasonography