6â9 October 2013, Sydney, Australia. Short oral presentation abstracts. OP18.03. Pelvic organ support in nulliparous Africans and Caucasians: a comparative ...
6–9 October 2013, Sydney, Australia
Short oral presentation abstracts
OP18.03 Pelvic organ support in nulliparous Africans and Caucasians: a comparative study using 4D pelvic floor ultrasound C. Shek1 , V. Wong1 , H. Krause2 , J. Goh2 , H. P. Dietz1 1 Department of Ob/Gyn, Sydney Medical School Nepean, Penrith, NSW, Australia; 2 Urogynaecology, Greenslopes Private Hospital, Newdgate, QLD, Australia
Objectives: There is substantial variation in the prevalence of pelvic floor disorders between ethnic groups. This may be due to differences in pelvic floor structure and functional anatomy. We undertook a study to compare hiatal dimensions, pelvic organ descent and levator biometry in young, healthy nulliparous Caucasians and Africans. Methods: Healthy nulliparous nonpregnant Ugandan volunteers underwent 4D translabial ultrasound, supine after bladder emptying, using a GE Voluson i ultrasound system with RAB 8-4Mhz transducer. To compare findings with those of nulliparous nonpregnant Caucasians, we retrieved the 3D/4D ultrasound volume datasets of two previously published studies. Hiatal dimensions, pelvic organ descent and levator muscle thickness were assessed offline using proprietary software. Results: The data sets of 76 Ugandan nuIliparae were compared with 66 nulliparous Caucasians. All measures of hiatal dimensions, bladder, uterine and rectal descent on Valsalva were significantly higher in the African group (see Table). Conclusions: Ugandans were found to have a much larger levator hiatus and greater pelvic organ mobility than Caucasians, by about one standard deviation. This implies greater distensibility of the levator ani muscle and higher elasticity of fascial support structures. While other causes such as lifestyle factors and nutrition may also be responsible, it appears likely that these differences are at least partly genetic in nature. Implications for childbirth- related fascial and muscular trauma are complex and deserve further study.
Parameter Hiatal area on Valsalva Max. muscle thickness Bladder neck descent on Valsalva in mm Uterine descent on Valsalva (mm above SP) Rectal descent on Valsalva (mm above SP)
Caucasians (n = 66)
Africans (n = 76)
P
15.72 (5.57) 6.59 (1.01) 16.2 (9.37)
23.15 (7.66) 6.34 (1.22) 23.4 (8.7)
