Tohoku J. Exp. Med., 2006, 210(4)

Impaired Function of the Levator Ani Muscle in the Grand Multipara and Great Grand Multipara

EROL KISLI,¹ MESUDE KISLI,² HAVVA AGARGUN,³ FILIZ ALTINOKYIGIT,³ MANSUR KAMACI,⁴ EKREM OZMAN⁵ and CETIN KOTAN¹

¹Department of General Surgery, School of Medicine, Yuzuncu Yil University, Van, Turkey, ²Department of Neurology, State Hospital, Van, Turkey, ³Department of Obstetric and Gynecology, State Hospital, Van, Turkey, ⁴Department of Obstetric and Gynecology, School of Medicine, Yuzuncu Yil University, Van, Turkey, ⁵Department of Urology, School of Medicine, Yuzuncu Yil University, Van, Turkey

Repeated deliveries might disturb the levator function and increase defecation disorders. In this prospective study, we determined the electric activity of the levator ani muscle (LAM) in nullipara, multipara, grand multipara, and great grand multipara (20 subjects for each group). Multiparity, grand multiparity, and great grand multiparity were defined as women having 2 - 5, 6 - 9, and 10 and over deliveries, respectively.? The number of deliveries of multipara, grand multipara and great grand multipara were 4.05 ± 1.14 (2 - 5), 7.55 ± 1.23 (6 - 9) and 12.2 ± 2.16 (10 - 17), respectively. All women were asked whether they had experienced constipation, fecal or urinary incontinence, and/or pelvic pain. All women were also evaluated for pelvic organ prolapse. Electromyography (EMG) of the LAM at rest and on contraction was recorded. EMG is an electrical recording of muscle activity. Constipation, incontinence and pelvic organ prolapse were encountered in multipara, grandmultipara and great grand multipara women. The LAM EMG at rest and on contraction in the nullipara was accepted as control. Both the resting and contractile activities of the LAM were as follows: nullipara > multipara > grand multipara > great grand multipara. These findings indicate that levator dysfunction and defecation disorders are increased with repeated deliveries because of pudendal and/or levator ani nerve injury and traumatic injury to the LAM occurred with the mechanical stresses of vaginal deliveries.

keywords —— electric activity; levator ani muscle; multipara; grand multipara; great grand multipara

© 2006 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2006, 210, 365-372

Correspondence: Dr. Erol Kisli, Tip Fakultesi Arastirma Hastanesi, Genel Cerrahi Anabilim Dali, Maras caddesi, 65200 Van, Turkey.

e-mail: erolkisli@hotmail.com