Study Results
Results pending
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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Recruitment Status
COMPLETED
Total Enrollment
40 participants
Study Classification
OBSERVATIONAL
Study Start Date
2013-05-31
Study Completion Date
2016-06-30
Brief Summary
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Interobserver variation in measuring the anovaginal distance (AVD) with perineal ultrasound
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Detailed Description
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Aims: This study describes perineal ultrasound measurement of the AVD in regard to ease of learning and interobserver agreement, in order to establish if the method is reliable to use in further research about objective postpartum description of perineal tears.
Methods: To educate the examiners, the method was shown and described by an experienced examiner. The examiners then measured the anovaginal distance in one woman repeatedly with until similar results (+/- 5 mm ) were achieved. The woman was in the lithotomy position and a vaginal ultrasound probe was used. The AVD in another 40 women was then measured and documented by two examiners, right after the other, who were blinded to the other´s results. The distance was measured between the mucosal margin of the internal anal sphincter and the vaginal probe. Interobserver agreement was calculated using Kappa-score.
Methods: To educate the examiners, the method was shown and described by an experienced examiner. The examiners then measured the anovaginal distance in one woman repeatedly with until similar results (+/- 5 mm ) were achieved. The woman was in the lithotomy position and a vaginal ultrasound probe was used. The AVD in another 40 women was then measured and documented by two examiners, right after the other, who were blinded to the other´s results. The distance was measured between the mucosal margin of the internal anal sphincter and the vaginal probe. Interobserver agreement was calculated using Kappa-score.
Conditions
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Pelvic Floor Disorders
Study Design
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Study Time Perspective
PROSPECTIVE
Study Groups
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anovaginal distance variation
3 measurements
anovaginal distance variation
Intervention Type
OTHER
Kappa calculation
Interventions
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anovaginal distance variation
Kappa calculation
Intervention Type
OTHER
Eligibility Criteria
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Inclusion Criteria
Examiners; the gynecologists authoring the study
Patients:
* any women visiting the gynaecological outpatient clinic of Linköping University Hospital where a vaginal ultrasound examination was performed
Patients:
* any women visiting the gynaecological outpatient clinic of Linköping University Hospital where a vaginal ultrasound examination was performed
Exclusion Criteria
Examiners: n/a
Patients:
* inability to understand spoken or written Swedish
Patients:
* inability to understand spoken or written Swedish
Minimum Eligible Age
20 Years
Maximum Eligible Age
100 Years
Eligible Sex
FEMALE
Accepts Healthy Volunteers
Yes
Sponsors
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Ostergotland County Council, Sweden
OTHER
Sponsor Role
lead
Responsible Party
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Eva Uustal
Senior consultant
Responsibility Role
PRINCIPAL_INVESTIGATOR
Principal Investigators
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Marie I Blomberg, MD PhD
Role: PRINCIPAL_INVESTIGATOR
head of department
References
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Faltin DL, Boulvain M, Floris LA, Irion O. Diagnosis of anal sphincter tears to prevent fecal incontinence: a randomized controlled trial. Obstet Gynecol. 2005 Jul;106(1):6-13. doi: 10.1097/01.AOG.0000165273.68486.95.
Reference Type
BACKGROUND
Starck M, Bohe M, Fortling B, Valentin L. Endosonography of the anal sphincter in women of different ages and parity. Ultrasound Obstet Gynecol. 2005 Feb;25(2):169-76. doi: 10.1002/uog.1818.
Reference Type
BACKGROUND
Andrews V, Sultan AH, Thakar R, Jones PW. Occult anal sphincter injuries--myth or reality? BJOG. 2006 Feb;113(2):195-200. doi: 10.1111/j.1471-0528.2006.00799.x.
Reference Type
BACKGROUND
Peschers UM, DeLancey JO, Schaer GN, Schuessler B. Exoanal ultrasound of the anal sphincter: normal anatomy and sphincter defects. Br J Obstet Gynaecol. 1997 Sep;104(9):999-1003. doi: 10.1111/j.1471-0528.1997.tb12056.x.
Reference Type
BACKGROUND
Poen AC, Felt-Bersma RJ, Cuesta MA, Meuwissen GM. Vaginal endosonography of the anal sphincter complex is important in the assessment of faecal incontinence and perianal sepsis. Br J Surg. 1998 Mar;85(3):359-63. doi: 10.1046/j.1365-2168.1998.00616.x.
Reference Type
BACKGROUND
Stewart LK, Wilson SR. Transvaginal sonography of the anal sphincter: reliable, or not? AJR Am J Roentgenol. 1999 Jul;173(1):179-85. doi: 10.2214/ajr.173.1.10397123.
Reference Type
BACKGROUND
Frudinger A, Bartram CI, Kamm MA. Transvaginal versus anal endosonography for detecting damage to the anal sphincter. AJR Am J Roentgenol. 1997 Jun;168(6):1435-8. doi: 10.2214/ajr.168.6.9168703.
Reference Type
BACKGROUND
Timor-Tritsch IE, Monteagudo A, Smilen SW, Porges RF, Avizova E. Simple ultrasound evaluation of the anal sphincter in female patients using a transvaginal transducer. Ultrasound Obstet Gynecol. 2005 Feb;25(2):177-83. doi: 10.1002/uog.1827.
Reference Type
BACKGROUND
Yang SH, Huang WC, Yang SY, Yang E, Yang JM. Validation of new ultrasound parameters for quantifying pelvic floor muscle contraction. Ultrasound Obstet Gynecol. 2009 Apr;33(4):465-71. doi: 10.1002/uog.6338.
Reference Type
BACKGROUND
Olsen IP, Wilsgaard T, Kiserud T. Transvaginal three-dimensional ultrasound: a method of studying anal anatomy and function. Ultrasound Obstet Gynecol. 2011 Mar;37(3):353-60. doi: 10.1002/uog.8873.
Reference Type
BACKGROUND
Valsky DV, Messing B, Petkova R, Savchev S, Rosenak D, Hochner-Celnikier D, Yagel S. Postpartum evaluation of the anal sphincter by transperineal three-dimensional ultrasound in primiparous women after vaginal delivery and following surgical repair of third-degree tears by the overlapping technique. Ultrasound Obstet Gynecol. 2007 Feb;29(2):195-204. doi: 10.1002/uog.3923.
Reference Type
BACKGROUND
Shobeiri SA, White D, Quiroz LH, Nihira MA. Anterior and posterior compartment 3D endovaginal ultrasound anatomy based on direct histologic comparison. Int Urogynecol J. 2012 Aug;23(8):1047-53. doi: 10.1007/s00192-012-1721-3. Epub 2012 Mar 9.
Reference Type
BACKGROUND
Falkert A, Willmann A, Endress E, Meint P, Seelbach-Gobel B. Three-dimensional ultrasound of pelvic floor: is there a correlation with delivery mode and persisting pelvic floor disorders 18-24 months after first delivery? Ultrasound Obstet Gynecol. 2013 Feb;41(2):204-9. doi: 10.1002/uog.11214.
Reference Type
BACKGROUND
Santoro GA, Shobeiri SA, Petros PP, Zapater P, Wieczorek AP. Perineal body anatomy seen by three-dimensional endovaginal ultrasound of asymptomatic nulliparae. Colorectal Dis. 2016 Apr;18(4):400-9. doi: 10.1111/codi.13119.
Reference Type
BACKGROUND
Sultan AH, Loder PB, Bartram CI, Kamm MA, Hudson CN. Vaginal endosonography. New approach to image the undisturbed anal sphincter. Dis Colon Rectum. 1994 Dec;37(12):1296-9. doi: 10.1007/BF02257800.
Reference Type
BACKGROUND
Larson KA, Yousuf A, Lewicky-Gaupp C, Fenner DE, DeLancey JO. Perineal body anatomy in living women: 3-dimensional analysis using thin-slice magnetic resonance imaging. Am J Obstet Gynecol. 2010 Nov;203(5):494.e15-21. doi: 10.1016/j.ajog.2010.06.008.
Reference Type
BACKGROUND
Uustal Fornell, E. The perineal body thickness - normal values and correlation to pelvic floor dysfunction. Abstract 344, IUGA 2005
Reference Type
BACKGROUND
Hall RJ, Rogers RG, Saiz L, Qualls C. Translabial ultrasound assessment of the anal sphincter complex: normal measurements of the internal and external anal sphincters at the proximal, mid-, and distal levels. Int Urogynecol J Pelvic Floor Dysfunct. 2007 Aug;18(8):881-8. doi: 10.1007/s00192-006-0254-z. Epub 2007 Jan 13.
Reference Type
BACKGROUND
Viera AJ, Garrett JM. Understanding interobserver agreement: the kappa statistic. Fam Med. 2005 May;37(5):360-3.
Reference Type
BACKGROUND
Santoro GA, Wieczorek AP, Shobeiri SA, Mueller ER, Pilat J, Stankiewicz A, Battistella G. Interobserver and interdisciplinary reproducibility of 3D endovaginal ultrasound assessment of pelvic floor anatomy. Int Urogynecol J. 2011 Jan;22(1):53-9. doi: 10.1007/s00192-010-1233-y. Epub 2010 Aug 11.
Reference Type
BACKGROUND
Zetterstrom JP, Mellgren A, Madoff RD, Kim DG, Wong WD. Perineal body measurement improves evaluation of anterior sphincter lesions during endoanal ultrasonography. Dis Colon Rectum. 1998 Jun;41(6):705-13. doi: 10.1007/BF02236256.
Reference Type
BACKGROUND
Ozyurt S, Aksoy H, Gedikbasi A, Yildirim G, Aksoy U, Acmaz G, Ark C. Screening occult anal sphincter injuries in primigravid women after vaginal delivery with transperineal use of vaginal probe: a prospective, randomized controlled trial. Arch Gynecol Obstet. 2015 Oct;292(4):853-9. doi: 10.1007/s00404-015-3708-z. Epub 2015 Apr 10.
Reference Type
BACKGROUND
Faltin DL, Boulvain M, Stan C, Epiney M, Weil A, Irion O. Intraobserver and interobserver agreement in the diagnosis of anal sphincter tears by postpartum endosonography. Ultrasound Obstet Gynecol. 2003 Apr;21(4):375-7. doi: 10.1002/uog.86.
Reference Type
RESULT
Other Identifiers
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OstergotlandCCAVD
Identifier Type: -
Identifier Source: org_study_id
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