{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T02:27:38Z","timestamp":1777516058773,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,4,2]],"date-time":"2019-04-02T00:00:00Z","timestamp":1554163200000},"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":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Levator ani muscle avulsions potentially increase recurrence after anterior colporrhaphies. We aimed at evaluating the impact of avulsions on anatomical and patient\u2010reported outcomes 1\u00a0year after the Manchester procedure for primary anterior compartment pelvic organ prolapse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Prospective cohort study of 189 women undergoing the Manchester procedure between October 2014 and January 2017. Avulsions were diagnosed by transperineal ultrasound. Women with and without avulsions were compared for 1\u2010year postoperative outcomes; Pelvic Organ Prolapse Quantification measurements, subjective satisfaction (1\u2014worse to 4\u2014cured), failure (new prolapse treatment), response to validated questionnaires on pelvic floor distress and sexual function, and a composite outcome (subjectively cured and optimal anterior compartment outcome (stage 0\u2010I)). Optimal mid\u2010compartment outcome was defined as cervix\u00a0\u22655\u00a0cm above the hymen. Factors potentially associated with poor anatomical outcomes (anterior compartment stage \u2265<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>) or pelvic floor distress were analyzed using regression analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fewer women with avulsions (present in 50.8%) obtained optimal mid\u2010compartment outcomes (88.2% vs 77.1%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.05). The groups were otherwise similar in terms of mid\u2010compartment reduction, anterior compartment results, failure rate, subjective satisfaction, pelvic floor\/sexual symptoms, and combined optimal subjective and anatomical outcome. Only preoperative anterior compartment stage \u2265<jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> was associated with poor anatomical outcome (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01). A high preoperative symptom score was associated with a high postoperative symptom score (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although fewer women with avulsions obtained optimal mid\u2010compartment results, avulsions had no impact on other anatomical or symptomatic outcomes 1\u00a0year after the Manchester procedure for primary anterior compartment prolapse.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13604","type":"journal-article","created":{"date-parts":[[2019,3,12]],"date-time":"2019-03-12T06:49:28Z","timestamp":1552373368000},"page":"1046-1054","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Impact of levator muscle avulsions on Manchester procedure outcomes in pelvic organ prolapse surgery"],"prefix":"10.1111","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0766-4523","authenticated-orcid":false,"given":"Sissel H.","family":"Oversand","sequence":"first","affiliation":[{"name":"Department of Gynecology Oslo University Hospital Oslo Norway"},{"name":"Faculty of Medicine University of Oslo Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne C.","family":"Staff","sequence":"additional","affiliation":[{"name":"Department of Gynecology Oslo University Hospital Oslo Norway"},{"name":"Faculty of Medicine University of Oslo Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9392-1674","authenticated-orcid":false,"given":"Ingrid","family":"Voll\u00f8yhaug","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Trondheim University Hospital Trondheim Norway"},{"name":"Department of Clinical and Molecular Medicine Norwegian University of Science and Technology Trondheim Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rune","family":"Svenningsen","sequence":"additional","affiliation":[{"name":"Department of Gynecology Oslo University Hospital Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,4,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-013-2169-9"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-014-2413-y"},{"key":"e_1_2_10_4_1","first-page":"CD004014","article-title":"Surgery for women with anterior compartment prolapse","volume":"11","author":"Maher C","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.119078"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181b2b1ae"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2008.01751.x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000250901.57095.ba"},{"key":"e_1_2_10_9_1","first-page":"1855","volume-title":"Incontinence","author":"Maher C","year":"2017"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12171"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7678"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-016-3100-y"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-018-3622-6"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-017-3390-8"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-013-2166-z"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)70243-0"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-010-1329-4"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.12.025"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-003-1063-2"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2011.01085.x"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-013-2307-4"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12433"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-011-1524-y"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-017-3475-4"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-014-2339-4"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-007-0321-0"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2010.07.046"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2011.02.020"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-011-1652-4"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2011.01315.x"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faogs.13604","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.13604","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.13604","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.13604","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T07:25:53Z","timestamp":1694330753000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.13604"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,2]]},"references-count":29,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1111\/aogs.13604"],"URL":"https:\/\/doi.org\/10.1111\/aogs.13604","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4,2]]},"assertion":[{"value":"2018-08-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-04-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}