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An interview, clinical examination and 3D\/4D transperineal ultrasound were performed at baseline and at 3-month follow-up. POP was assessed using the Pelvic Organ Prolapse Quantification system (POPQ). Parameters compared between baseline and follow-up were: hiatal area at rest (HArest), maximal contraction (HActx), and maximal Valsalva maneuver (HAVal), displacement in contraction (DISPL-ctx, i.e., relative difference between HArest and HActx), and displacement in Valsalva (DISPL-Val, i.e., relative difference between and HAVal and HArest). Parameters were compared in women with and those without complete avulsion.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 162 women were assessed and 34 were included. Mean age was 64\u00a0years (SD 11.4), and mean BMI 24\u00a0kg\/m<jats:sup>2<\/jats:sup> (SD 3.1). Thirty-one women had a cystocele, 8 a uterine prolapse, and 12 had a posterior compartment prolapse. Twenty-one women (61.8%) had a POP stage II, and 13 (38.2%) a POP stage III. Ring pessaries were most frequently used (97%). In the entire group a statistically significant increase in DISPL-ctx was observed (mean difference 2.1%, <jats:italic>p<\/jats:italic>\u2009=\u20090.017). In the no avulsion group HArest and DISPL-ctx increased significantly (mean difference 4.1%, <jats:italic>p<\/jats:italic>\u2009=\u20090.016 and 2.7%, <jats:italic>p<\/jats:italic>\u2009=\u20090.016 respectively) and the increase in DISPL-ctx was higher than in the avulsion group (mean difference 2.7% vs 0.2%, <jats:italic>p<\/jats:italic>\u2009=\u20090.056).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Our results show that PRM function changes in women with POP undergoing pessary treatment and suggest that such change occurs mainly in the absence of complete avulsion.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00192-021-04766-2","type":"journal-article","created":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T09:04:04Z","timestamp":1618304644000},"page":"1409-1417","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The effect of pessary treatment on puborectalis muscle function"],"prefix":"10.1007","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5265-7915","authenticated-orcid":false,"given":"Claudia","family":"Manzini","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frieda","family":"van den Noort","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anique T. 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