{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T04:23:43Z","timestamp":1775795023299,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T00:00:00Z","timestamp":1719964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T00:00:00Z","timestamp":1719964800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine whether height, weight and body mass index (BMI) are associated with the levator\u2013urethra gap (LUG) measurement, and whether these factors confound the relationship between LUG and symptoms and signs of pelvic organ prolapse (POP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective study of women seen at a tertiary urogynecology unit between January 2020 and December 2021. Postprocessing of saved ultrasound volume data was used to measure the LUG, blinded against all other data. This measurement was tested for its association with organ descent and hiatal area, and height, weight and BMI were investigated for any potential confounding effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 624 women seen during the inclusion period presented mostly with stress urinary incontinence (448\/624 (72%)), urgency urinary incontinence (469\/624 (75%)) and\/or prolapse (338\/624 (54%)). Mean age at assessment was 58 (range, 20\u201394) years, mean height was 163 (range, 142\u2013182) cm, mean weight was 80 (range, 41\u2013153) kg and mean BMI was 30 (range, 17\u201365) kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . LUG measurements could be obtained in 613 women, resulting in 7356 (12\u2009\u00d7\u2009613) measurements. The average LUG in individual women measured 2.35\u2009cm on the right and 2.32\u2009cm on the left side (difference not significant), with a mean\u2009\u00b1\u2009SD of 2.34\u2009\u00b1\u20090.63\u2009cm overall. Mean LUG was associated with symptoms and signs of prolapse, both on clinical examination (POP quantification system) and on imaging, but not with height (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.36), weight (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.20) or BMI (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.09).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Levator\u2013urethra gap measurements do not seem to be significantly associated with height, weight or BMI in our population, obviating the need for individualization of LUG. However, this does not exclude interethnic variability of this biometric measure. \u00a9 2024 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.27706","type":"journal-article","created":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T11:09:45Z","timestamp":1716376185000},"page":"253-258","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Levator\u2013urethra gap: is there a need for individualization of cut\u2010offs?"],"prefix":"10.1002","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2211-6149","authenticated-orcid":false,"given":"H. P.","family":"Dietz","sequence":"first","affiliation":[{"name":"Sydney Urodynamic Centres  Penrith NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6836-4474","authenticated-orcid":false,"given":"K. L.","family":"Shek","sequence":"additional","affiliation":[{"name":"Western Sydney University  Liverpool NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Descallar","sequence":"additional","affiliation":[{"name":"South Western Sydney Local Health District  Liverpool NSW Australia"},{"name":"Ingham Institute for Applied Medical Research  Liverpool NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,3]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-020-04669-8"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2010.05.019"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000178779.62181.01"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.3951"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-019-03954-5"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000304"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-022-05354-8"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.03.004"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200203000-00011"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-010-1329-4"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.20250"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.20181"},{"issue":"2","key":"e_1_2_7_14_1","first-page":"S274","article-title":"Coronal plane imaging of levator trauma","volume":"33","author":"Dietz H","year":"2022","journal-title":"Int Urogynecol J"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-009-0839-4"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6268"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11192"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-015-2909-0"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/SPV.0000000000000311"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/SPV.0000000000001115"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14208"},{"key":"e_1_2_7_22_1","first-page":"43","article-title":"Is it useful to distinguish type I and type II avulsions?","volume":"62","author":"Dietz H","year":"2023","journal-title":"Int Urogynecol J"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26034"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.03.052"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)70243-0"},{"issue":"1","key":"e_1_2_7_26_1","first-page":"S 132\u20103","article-title":"Is a visual analogue scale inferior to the PFDI for assessing symptom bother of pelvic organ prolapse?","volume":"25","author":"Shek K","year":"2019","journal-title":"Female Pelvic Med Reconstr Surg"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1899"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14719"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15832"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.14644"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.02.020"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.254"},{"key":"e_1_2_7_33_1","first-page":"532","article-title":"Variations in levator ani volume and geometry in women: the application of MR based 3D reconstruction in evaluating pelvic floor dysfunction","volume":"54","author":"Hoyte L","year":"2001","journal-title":"Arch Esp Urol"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7587"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-017-3391-7"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20124"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15881"}],"container-title":["Ultrasound in Obstetrics &amp; 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