Irreversible traumatic distension of the levator hiatus: authors’ reply

Thank you for asking me to comment on Dr Kapoor’s letter.1 He raises several interesting questions regarding our study recently published in BJOG.2 The percentage of episi-otomy in the 32 women diagnosed with levator avulsion was 41% (13/32). A total of 56% (18/32) had perineal tears of any degree, and 22% (7/32) sustained a major perineal tear. The corresponding figures for the group of women diagnosed with levator microtrauma was 25% (14/57), 47%(27/57) and 7% (4/57), respectively. Forty-two women had a normal vaginal delviery, and 11 had a vacuum and four had a forceps delivery.