EP26.10: Vaginal wall elasticity was similar in postpartum women with or without levator muscle injury: a pilot study

While vaginal wall elasticity is an important aspect of maintaining good vaginal health, the factors that determine vaginal elasticity in the postpartum period are relatively poorly understood. Our study aimed to evaluate the contribution of the levator muscle injury to vaginal wall elasticity in postpartum women. A cross-sectional study was performed six weeks after vaginal delivery. Elastographic parameters of the vaginal walls were measured using strain ultrasound elastography in four regions of interest (ROI) in the anterior and four in the posterior vaginal wall. The Elastography Index (EI) was defined as the average colour score of four ROIs on each side of the vagina. The levator-urethra gap (LUG) was measured on 3D ultrasound images as the distance between the centre of the urethra and the levator insertion bilaterally. Based on previous studies, an abnormal LUG≥25mm indicated levator avulsion. Groups were compared with unpaired t-tests. Fifty-one subjects were included in the study (14 had unilateral, 11 had bilateral avulsion, and 27 had no sign of avulsion). The EI did not differ significantly between any defect (unilateral and bilateral defect) and no-defect groups measured on the anterior vaginal wall (mean ± SD, 25.03 ± 23.65 vs. 25.30 ± 22.73, NS) and also on the posterior vaginal wall (mean ± SD, 38.68 ± 24.67 vs. 46.31 ± 16.48, NS). Similarly, we examined EI between the bilateral avulsion and no-defect groups, where there was also no significant difference in either the anterior (mean ± SD, 24.1 ± 0.83 vs. 25.30 ± 22.73, NS) or posterior (mean ± SD, 46.02 ± 14.71 vs. 46.31 ± 16.48, NS) vaginal wall. Our results suggest that levator muscle injury may not contribute significantly to vaginal elasticity in postpartum women.