{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:00:17Z","timestamp":1769817617298,"version":"3.49.0"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"01","funder":[{"name":"Chongqing Medical Research Projects of China","award":["2012-1-076"],"award-info":[{"award-number":["2012-1-076"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ultraschall Med"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Purpose\u2002To determine the association between levator avulsion and urinary stress incontinence (USI) by 3\/4D transperineal ultrasound.<\/jats:p><jats:p>\n          Materials and Methods\u2002842 patients who were admitted to our hospital from 2016 to 2019 were recruited for our study. 3D\/4D transperineal ultrasound was performed. After standard interview and clinical evaluation, general conditions and levator hiatus data were collected and measured to compare with each group.\u200aThe odds ratio (OR) of USI symptoms or ultrasound features with levator avulsion were calculated.<\/jats:p><jats:p>\n          Results\u2002A total of 593 women were studied: 204 suffered from levator avulsion (96 cases of left-side avulsion, 80 cases of right-side avulsion and 28 cases of bilateral avulsion) and 389 women had no avulsion. The gravidity and episiotomy conditions of the avulsion groups were significantly different from the no-avulsion group.\u200aSignificant differences were found in the transverse diameters and anteroposterior diameters between the levator avulsion group and the no-avulsion group, but there was no difference among the avulsion groups, regardless of whether the patient was at rest or performing the Valsalva maneuver. Interestingly, a significant difference was found in the presence of USI symptoms between the uni-avulsion group and the no-avulsion group.\u200aThe odds ratio (OR) of USI symptoms in the uni-avulsion group is 2.786 (95\u200a%CI, 1.663\u20134.669), but 0.939 (95\u200a%CI, 0.276\u20133.199) for the bilateral avulsion and no-avulsion groups.<\/jats:p><jats:p>\n          Conclusion\u2002Unilateral levator avulsion may be a risk factor for urinary stress incontinence.<\/jats:p>","DOI":"10.1055\/a-1497-1838","type":"journal-article","created":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T15:27:06Z","timestamp":1621956426000},"page":"e39-e46","source":"Crossref","is-referenced-by-count":11,"title":["Association Between Urinary Stress Incontinence and Levator Avulsion Detected by 3D Transperineal Ultrasound"],"prefix":"10.1055","volume":"44","author":[{"given":"Chunyan","family":"Zhong","sequence":"first","affiliation":[{"name":"Ultrasound, Chongqing Health Center for Women and Children, Chongqing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pan","family":"Hu","sequence":"first","affiliation":[{"name":"Gynecological pelvic floor and oncology, Chongqing Health Center for Women and Children, Chongqing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzhen","family":"Ran","sequence":"additional","affiliation":[{"name":"Ultrasound, Chongqing Health Center for Women and Children, Chongqing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Tang","sequence":"additional","affiliation":[{"name":"Ultrasound, Chongqing Health Center for Women and Children, Chongqing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunmei","family":"Xiao","sequence":"additional","affiliation":[{"name":"Ultrasound, Chongqing Health Center for Women and Children, Chongqing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun","family":"Lin","sequence":"additional","affiliation":[{"name":"Ultrasound, Chongqing Health Center for Women and Children, Chongqing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaohang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Ultrasound, Chongqing Health Center for Women and Children, Chongqing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Rong","sequence":"additional","affiliation":[{"name":"Ultrasound, Chongqing Health Center for Women and Children, Chongqing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingbo","family":"Liu","sequence":"additional","affiliation":[{"name":"Gynecological pelvic floor and oncology, Chongqing Health Center for Women and Children, Chongqing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,5,20]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1067\/mob.2003.101","article-title":"Procedures for pelvic organ prolapse in the United States, 1979\u20131997","volume":"188","author":"S H Boyles","year":"2003","journal-title":"Am J Obstet Gynecol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/S0022-5347(05)00242-9","article-title":"Urologic Diseases of America Project. 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