Journal of Medical Ultrasound

BRIEF COMMUNICATION
Year
: 2020  |  Volume : 28  |  Issue : 4  |  Page : 245--248

Physiotherapeutic treatment for levator ani avulsion after delivery: A transperineal three-dimensional ultrasound assessment


Juliana Sayuri Kubotani1, Edward Araujo Júnior1, Andrea Silveira de Queiroz Campo2, Jurandir Piassi Passos1, Caroline Ferreira do Nascimento Neri3, Miriam Raquel Diniz Zanetti3 
1 Department of Obstetrics, Paulista School of Medicine, Federal University of Sao Paulo (EPM-UNIFESP), Sao Paulo, Brazil
2 Moara Health Clinic, São Paulo, Brazil
3 Department of Human Movement Science, Federal University of São Paulo, Baixada Santista Campi (UNIFESP), Santos, São Paulo, Brazil

Correspondence Address:
Prof. Edward Araujo Júnior
Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, Sao Paulo
Brazil

Background: Levator ani avulsion is defined as the interruption of the insertion of this muscle on the pubic bone. It is currently recognized as an important triggering factor for genital prolapse. Although surgical interventions are available, there are no conservative strategies for this muscular injury. Description: A 40-year-old female presented with urinary incontinence and levator ani avulsion, which was confirmed on transperineal three-dimensional ultrasound (3DUS). Upon referral for physiotherapy, she presented with incorrect and weak contractions of the pelvic floor. Her treatment comprised 13 sessions of intravaginal electrotherapy followed by pelvic floor muscle (PFM) exercises in different positions. At the end of the sessions, another transperineal 3DUS was performed, and it revealed rapprochement of the levator ani muscle. The avulsed levator ani muscle can be reinserted using physiotherapeutic interventions, especially a combination of electrotherapy and PFM exercises. Conclusion: Transperineal 3DUS is an important approach for the follow-up of conservative treatment until full recovery.


How to cite this article:
Kubotani JS, Júnior EA, Queiroz Campo AS, Passos JP, Nascimento Neri CF, Diniz Zanetti MR. Physiotherapeutic treatment for levator ani avulsion after delivery: A transperineal three-dimensional ultrasound assessment.J Med Ultrasound 2020;28:245-248


How to cite this URL:
Kubotani JS, Júnior EA, Queiroz Campo AS, Passos JP, Nascimento Neri CF, Diniz Zanetti MR. Physiotherapeutic treatment for levator ani avulsion after delivery: A transperineal three-dimensional ultrasound assessment. J Med Ultrasound [serial online] 2020 [cited 2022 Aug 18 ];28:245-248
Available from: http://www.jmuonline.org/article.asp?issn=0929-6441;year=2020;volume=28;issue=4;spage=245;epage=248;aulast=Kubotani;type=0