{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T20:04:12Z","timestamp":1771013052181,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,7,26]],"date-time":"2013-07-26T00:00:00Z","timestamp":1374796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Levator avulsion has been shown to be a predictor of cystocele recurrence following anterior colporrhaphy. The aim of this study was to determine if levator avulsion is a risk factor for prolapse recurrence following anterior colporrhaphy with mesh.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective analysis of data obtained from three surgical audits for subjective and objective outcomes following anterior colporrhaphy with mesh. Recurrence was defined as cystocele \u2265 Stage 2 on the prolapse quantification system of the International Continence Society; symptoms of vaginal lump\/bulge; or cystocele on ultrasound, defined as maximum bladder descent to \u2265\u200910\u2009mm below the symphysis pubis. Levator avulsion was diagnosed using tomographic ultrasound imaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred and nine patients were followed up at a mean of 2.2\u2009years (range, 3\u2009months to 5.6\u2009years) after anterior vaginal mesh placement. 24% (51\/209) had recurrent prolapse symptoms, 33% (68\/209) clinical cystocele recurrence \u2265 Stage 2, and 26% (54\/209) a recurrent cystocele on ultrasound. Twenty\u2010eight out of 80 (35%) women with levator avulsion had significant sonographic cystocele recurrence (odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>), 2.24 (95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>), 1.13\u20134.43)). This finding was confirmed after adjusting for potential predictors of prolapse recurrence on multivariate logistic regression (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 2.13 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.04\u20134.39); <jats:italic>P<\/jats:italic> = 0.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Levator avulsion doubles the risk of cystocele recurrence after anterior colporrhaphy with transobturator mesh. Copyright \u00a9 2013 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.12433","type":"journal-article","created":{"date-parts":[[2013,2,12]],"date-time":"2013-02-12T18:23:04Z","timestamp":1360693384000},"page":"230-234","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Is levator avulsion a predictor of cystocele recurrence following anterior vaginal mesh placement?"],"prefix":"10.1002","volume":"42","author":[{"given":"V.","family":"Wong","sequence":"first","affiliation":[{"name":"Sydney Medical School Nepean University of Sydney Penrith New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Shek","sequence":"additional","affiliation":[{"name":"Sydney Medical School Nepean University of Sydney Penrith New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Rane","sequence":"additional","affiliation":[{"name":"James Cook University Townsville Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Goh","sequence":"additional","affiliation":[{"name":"Greenslopes Private Hospital Newdegate, Greenslopes Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Krause","sequence":"additional","affiliation":[{"name":"Greenslopes Private Hospital Newdegate, Greenslopes Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. 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