Luyun Chen1,2, Carolyn W Swenson1,3, Wenjin Cheng4,5, Mary Duarte Thibault1, John O DeLancey1. 1. Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA. 2. Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA. 3. University of Utah Health, Salt Lake City, UT, USA. 4. Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA. wenjinc525@yahoo.com. 5. Department of Obstetrics and Gynecology, Beaumont Dearborn, 18101 Oakwood Blvd, Dearborn, MI, USA. wenjinc525@yahoo.com.
Abstract
INTRODUCTION AND HYPOTHESIS: The objective was to test the hypotheses that a linear relationship exists between age and levator bowl volume (LBV); and that age, parity, and prolapse are independently associated with LBV. METHODS: We conducted a secondary analysis of data from nulliparous women, parous controls, and prolapse (Pelvic Organ Prolapse Quantification (POP-Q) Ba ≥ 1 cm) cases from each of three age groups: young (≤40), mid-age (50-60), and older (≥70). LBV was measured using MRI at rest and Valsalva as the 3D space contained above the levator ani muscles and below the sacrococcygeal junction-to-inferior pubic point reference plane. Linear regression models were used to examine the effects of age, parity, prolapse, and their interactions (age*parity and age*prolapse) on LBV. RESULTS: Each group consisted of 9-12 women. LBVRest increased with age in a nonlinear fashion. For nulliparous women, the median value increased 4.7% per decade from the young to mid-age group and 84% per decade from the mid-age to older group; for parous controls, the corresponding increases were 38% and -0.5%; and for women with prolapse, they were 46% and 11%. Age and prolapse status (both p<0.001) were found to be significant independent predictors of LBVRest. Interactions between age*prolapse (p=0.003) and age*parity (p=0.045) were also independently associated with LBVRest. CONCLUSIONS: Parity and prolapse influence how age affects LBVRest. In nulliparous women, age had little effect on LBVRest until after mid-age. For women with prolapse, LBVRest increased at a much earlier age, with the biggest difference occurring between young and mid-age women.
INTRODUCTION AND HYPOTHESIS: The objective was to test the hypotheses that a linear relationship exists between age and levator bowl volume (LBV); and that age, parity, and prolapse are independently associated with LBV. METHODS: We conducted a secondary analysis of data from nulliparous women, parous controls, and prolapse (Pelvic Organ Prolapse Quantification (POP-Q) Ba ≥ 1 cm) cases from each of three age groups: young (≤40), mid-age (50-60), and older (≥70). LBV was measured using MRI at rest and Valsalva as the 3D space contained above the levator ani muscles and below the sacrococcygeal junction-to-inferior pubic point reference plane. Linear regression models were used to examine the effects of age, parity, prolapse, and their interactions (age*parity and age*prolapse) on LBV. RESULTS: Each group consisted of 9-12 women. LBVRest increased with age in a nonlinear fashion. For nulliparous women, the median value increased 4.7% per decade from the young to mid-age group and 84% per decade from the mid-age to older group; for parous controls, the corresponding increases were 38% and -0.5%; and for women with prolapse, they were 46% and 11%. Age and prolapse status (both p<0.001) were found to be significant independent predictors of LBVRest. Interactions between age*prolapse (p=0.003) and age*parity (p=0.045) were also independently associated with LBVRest. CONCLUSIONS: Parity and prolapse influence how age affects LBVRest. In nulliparous women, age had little effect on LBVRest until after mid-age. For women with prolapse, LBVRest increased at a much earlier age, with the biggest difference occurring between young and mid-age women.
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