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Article

The Role of Transperineal Ultrasound for the Assessment of the Anorectal Angle and Its Relationship with Levator Ani Muscle Avulsion

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Department of Obstetrics and Gynecology, Valme University Hospital, 41014 Seville, Spain
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Department of Obstetrics and Gynecology, University of Seville, 41014 Seville, Spain
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Biostatistics Unit, Department of Preventive Medicine and Public Health, University of Seville, 41014 Seville, Spain
*
Authors to whom correspondence should be addressed.
Academic Editor: Emilio Quaia
Tomography 2022, 8(3), 1270-1276; https://doi.org/10.3390/tomography8030105
Received: 21 March 2022 / Revised: 28 April 2022 / Accepted: 1 May 2022 / Published: 6 May 2022
The relationship between the anorectal angle (ARA) and the levator ani muscle (LAM) is well known. In this study, we aimed to demonstrate that the ARA changes when LAM avulsion occurs after vaginal delivery. This was a secondary, observational retrospective study with data obtained from three previous studies. Using transperineal ultrasound, the presence of avulsion was assessed when abnormal insertion of the LAM was observed in three central slices. In addition, the ARA was assessed in the midsagittal plane (at rest, in Valsalva and at maximum contraction) as the angle between the posterior border of the distal part of the rectum and the central axis of the anal canal. The ARA was higher in patients with bilateral LAM avulsion than in patients without LAM avulsion at rest (131.8 ± 14.1 vs. 136.2 ± 13.8), in Valsalva (129.4 ± 15.5 vs. 136.5 ± 14.4) and at maximum contraction (125.7 ± 15.5 vs. 132.3 ± 13.2). The differences between both groups expressed as the odds ratio (OR) adjusted for maternal age were 1.031 (95% confidence interval (CI), 1.001–1.061; p = 0.041) at rest, 1.036 (95% CI, 1.008–1.064; p = 0.012) in Valsalva and 1.031 (95% CI, 1.003–1.059; p = 0.027) at maximum contraction. In conclusion, LAM avulsion produces an increase in the ARA at rest, during contraction and in Valsalva, especially in cases of bilateral LAM avulsion. View Full-Text
Keywords: anorectal angle; levator ani muscle; avulsion; ultrasound; transperitoneal ultrasound; pelvic floor anorectal angle; levator ani muscle; avulsion; ultrasound; transperitoneal ultrasound; pelvic floor
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MDPI and ACS Style

García-Mejido, J.A.; García-Pombo, S.; Fernández-Conde, C.; Borrero, C.; Fernández-Palacín, A.; Sainz-Bueno, J.A. The Role of Transperineal Ultrasound for the Assessment of the Anorectal Angle and Its Relationship with Levator Ani Muscle Avulsion. Tomography 2022, 8, 1270-1276. https://doi.org/10.3390/tomography8030105

AMA Style

García-Mejido JA, García-Pombo S, Fernández-Conde C, Borrero C, Fernández-Palacín A, Sainz-Bueno JA. The Role of Transperineal Ultrasound for the Assessment of the Anorectal Angle and Its Relationship with Levator Ani Muscle Avulsion. Tomography. 2022; 8(3):1270-1276. https://doi.org/10.3390/tomography8030105

Chicago/Turabian Style

García-Mejido, José A., Sara García-Pombo, Cristina Fernández-Conde, Carlota Borrero, Ana Fernández-Palacín, and José A. Sainz-Bueno. 2022. "The Role of Transperineal Ultrasound for the Assessment of the Anorectal Angle and Its Relationship with Levator Ani Muscle Avulsion" Tomography 8, no. 3: 1270-1276. https://doi.org/10.3390/tomography8030105

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