Explanipedia

O&G professionals’ understanding of levator and OASI Injuries, their views on antenatal counselling and obtaining informed consent for obstetric interventions: An online survey Open

Lynne Stuart, Ka Lai Shek, Hans Peter Dietz · 2025

Levator trauma is much less well recognized than OASI. A lack of standard teaching may be contributory and may constitute one of the challenges in patient counselling and obtaining informed consent for obstetric interventions, supported by…

Is two‐dimensional oblique parasagittal ultrasound imaging valid for levator ani muscle assessment? Open

Ka Lai Shek, Hans Peter Dietz · 2025

Objective To evaluate the validity of two‐dimensional (2D) oblique parasagittal ultrasound imaging to assess levator ani muscle avulsion. Methods This was a cross‐sectional prospective study of women attending a tertiary urogynecological s…

The Patient Is Dying of Drug Poisoning—Let's Increase the Dosage! Open

Hans Peter Dietz, Susanne Langer, Ka Lai Shek, John Pardey · 2025

The recently completed Select Committee of the NSW Upper House into Birth Trauma has caused consternation amongst colleagues and triggered a controversial response from the NSW Government. It is high time that our college started to fight …

OC18.07: Are MRI‐based scoring systems equivalent to standard tomographic assessment of avulsion? Open

Hans Peter Dietz, Ka Lai Shek · 2023

Levator avulsion is the primary etiological factor of pelvic organ prolapse (POP). Some authors have used MRI- based scoring systems on translabial US, for which a different scoring system was developed initially. We aimed to compare the t…

OP15.01: Can we define a cut‐off for sphincter defect angle? Open

H. Dietz, Ka Lai Shek, Joseph Descallar · 2023

Postnatally, benign SD were applicable in 111 (65.7%) masses; one (0.9%) BOT was misclassified.The two-step strategy had a sensitivity of 50.0% and a specificity of 96.9%.In pregnancy and postnatally, 2.2% had a cyst-related complication: …

OC18.01: Is improved voiding associated with improved urgency urinary incontinence after prolapse repair? Open

Victoria Buckley, Ka Lai Shek, H. P. Dietz · 2023

2. The sensitivity of colour flow in early pregnancy to show the four chamber heart combined with slowflowHD in judging the normal structure of the fetal heart was 81.93%, the specificity was 97.46%, the AUC = 0.90, the disease prevalence …

OC18.08: Is it useful to distinguish type I and type II avulsions? Open

H. Dietz, Ka Lai Shek, Joseph Descallar · 2023

Levator avulsion is a common observation in women with pelvic organ prolapse (POP). It was recently proposed that a distinction should be made between type I (hyperechoic ‘connection’ to sidewall) and type II avulsion (no such ‘connection’…

EP34.01: Do levator avulsions heal? Open

H. Dietz, Ka Lai Shek, Joseph Descallar · 2023

Levator avulsion is a common traumatic consequence of vaginal birth. The natural history of partial trauma is less clear as compensatory hypertrophy of remnant muscle may alter appearances over time. The study was designed to analyse chang…

Ultrasound imaging of slings and meshes in urogynecology Open

Ka Lai Shek, Hans Peter Dietz · 2020

Imaging is used increasingly in urogynecology. One of the main applications is in the assessment of synthetic implants. Ultrasound is particularly useful for this purpose as most such implants appear highly echogenic on ultrasound but are …

VP67.05: Characteristics of episiotomy on translabial ultrasound Open

N. Subramaniam, Ka Lai Shek, Hans Peter Dietz · 2020

To describe imaging characteristics of episiotomy scars on TLUS. The direction was determined as an angle relative to the vertical. Scar depth was calculated using the formula cos θ*b. The datasets of 84 women were analsyed. Mean follow-up…

VP68.04: Is levator avulsion associated with vaginal laxity Open

J. Alexander, M. Gillor, Ka Lai Shek, Hans Peter Dietz · 2020

To determine if levator avulsion is independently associated with the symptom of vaginal laxity. A retrospective observational study of patients seen for pelvic floor dysfunction at a tertiary uorgynecological clinic between May 16 and Mar…

VP67.02: Twisting of transobturator midurethral slings: does it matter? Open

M. Gillor, Ka Lai Shek, Hans Peter Dietz · 2020

To evaluate twisting of transobturator midurethral slings (TOT) and assess any association with pain. This was a retrospective study of patients after TOT surgery. Sling rotation was assessed in archived 4D pelvic floor ultrasound (PFUS) v…

Is location of urethral kinking a confounder of association between urethral closure pressure and stress urinary incontinence? Open

Chau Wei Ling, Ka Lai Shek, M. Gillor, Jessica Caudwell‐Hall, Hans Peter Dietz · 2020

Objectives Intact urethral support and normal sphincter function are deemed important for urinary continence. We aimed to test whether the location of urethral kinking (as the probable anatomical correlate of maximal pressure transmission)…

How comparable is clinical grading of obstetric anal sphincter injury with that determined by four‐dimensional translabial ultrasound? Open

M. Gillor, Ka Lai Shek, Hans Peter Dietz · 2020

Objectives To evaluate the agreement between grading of obstetric anal sphincter injuries (OASI) on translabial ultrasound (TLUS), using a newly developed algorithm, and grading on postpartum examination. A secondary aim was to assess the …

EP27.29: Has the prevalence of avulsion after forceps delivery changed over time? Open

S. Arcanjo, Jessica Caudwell‐Hall, Ka Lai Shek, Hans Peter Dietz · 2019

Forceps delivery (FD) is a strong risk factor for avulsion. While rates of FD have declined, concerns have arisen over inadequate training, potentially leading to an increase in major pelvic floor trauma. The aim of this study was to deter…

P16.09: Obstetric risk factors for levator avulsion: a meta‐analysis and systematic review Open

N. Subramaniam, Guy D. Eslick, Ka Lai Shek, H. P. Dietz · 2019

70% of the mothers-to-be when receiving genetic abnormalities, 2 still felt suicidal.Conclusions: In most pregnant women the conduct of the invasive procedure itself significantly improved emotional tension, while feelings after result rev…

OP01.05: How accurate is the clinical diagnosis of obstetric anal sphincter injury? Open

M. Gillor, Ka Lai Shek, Hans Peter Dietz · 2019

To evaluate agreement between clinical diagnosis of obstetric anal sphincter injury (OASI) and diagnosis by translabial ultrasound (TLUS) on 3 month follow-up. A retrospective study on 260 patients seen on average 3 months after OASI. 45 w…

OC27.04: Does urethral kinking affect the association between urethral closure pressure and SUI? Open

L. Chen, Ka Lai Shek, M. Gillor, Hans Peter Dietz · 2019

Intact urethral support and normal sphincter closure are deemed important for urinary continence. The former allows pressure transmission when intra-abdominal pressure rises and may augment urethral sphincter pressures. The closer the locu…

Notes for Contributors Open

Anthony Odibo, Alexandros Sotiriadis, Karl Oliver Kagan, Juan Luis Alcázar, Peter Spain , et al. · 2019

Notes to Contributors Open

Anthony Odibo, Alexandros Sotiriadis, Karl Oliver Kagan, Juan Luis Alcázar, Peter Spain , et al. · 2019

Definition of apical descent in women with and without previous hysterectomy: A retrospective analysis Open

Gerda Trutnovsky, Kristy Robledo, Ka Lai Shek, Hans Peter Dietz · 2019

A cut- off for 'significant central compartment descent' of 5 cm above the hymen on Valsalva seems valid regardless of previous hysterectomy.

Notes to Contributors Open

Anthony Odibo, Alexandros Sotiriadis, Karl Oliver Kagan, Juan Luis Alcázar, Peter Spain , et al. · 2019

Pelvic organ prolapse in Caucasian and East Asian women: a comparative study Open

Rachel Yau Kar Cheung, Symphorosa Shing Chee Chan, Ka Lai Shek, Tony K.H. Chung, Hans Peter Dietz · 2018

Objective Ethnicity has been suggested to be a significant risk factor for pelvic organ prolapse (POP); yet, pelvic organ descent in different ethnic groups, especially in Asian populations, is not well studied. The aim of this study was t…

Changes in urethral mobility and configuration after prolapse repair Open

Lieming Wen, Ka Lai Shek, Hans Peter Dietz · 2018

Objective To evaluate changes in urethral mobility and configuration after prolapse repair. Methods This was a retrospective study of 92 patients who were examined between 2005 and 2016 before and after surgery for pelvic organ prolapse (P…

Can pelvic floor trauma be predicted antenatally? Open

Jessica Caudwell‐Hall, Ixora Kamisan Atan, Chris Brown, Rodrigo Guzmán Rojas, Susanne Langer , et al. · 2018

Introduction Levator trauma is a risk factor for the development of pelvic organ prolapse. We aimed to identify antenatal predictors for significant damage to the levator ani muscle during a first vaginal delivery. Material and methods A r…

P07.05: Prevalence of levator trauma and delivery mode Open

Ka Lai Shek, H. P. Dietz · 2017

Childbirth is a known risk factor for pelvic organ prolapse (POP). Levator ani muscle injury is likely part of the missing link. The aim of the study is to determine the prevalence of levator trauma in a urogynecological population, relati…

OC20.07: Is there an association between imaging and urodynamic findings after suburethral sling? Open

Lieming Wen, Ka Lai Shek, N. Subramaniam, Talia Friedman, Hans Peter Dietz · 2017

To study the correlation between sonographic appearances of suburethral slings (SUS) and urodynamic findings. This is a retrospective study on 126 women seen for symptoms of pelvic floor or lower urinary tract dysfunction after SUS. All ha…

OC20.05: Changes in urethral mobility and kinking after prolapse repair Open

Lieming Wen, Ka Lai Shek, N. Subramaniam, Talia Friedman, Hans Peter Dietz · 2017

To evaluate changes in urethral mobility and urethral kinking after surgery for pelvic organ prolapse (POP). This is a retrospective study on 92 patients after surgery for pelvic organ prolapse (POP) without concomitant anti-incontinence s…

The mesh debate: Transvaginal anterior anchored mesh should not be abandoned Open

Vivien Wong, Ka Lai Shek · 2017

Authors' reply re: Does the Epi‐No birth trainer prevent vaginal birth‐related pelvic floor trauma? A multicenter prospective randomised controlled trial Open

Hans Peter Dietz, Ixora Kamisan Atan, Susanne Langer, Ka Lai Shek, Rodrigo Guzmán Rojas , et al. · 2016

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