To determine the diagnostic accuracy of transperineal ultrasound, endovaginal ultrasound and vaginal assessment for the detection of major levator ani muscle avulsion in women, using MRI as the reference standard, with a view to make recommendations regarding the ideal investigation to diagnose levator ani muscle avulsion.

1. To determine the diagnostic accuracy of MRI, transperineal ultrasound, endovaginal ultrasound and vaginal assessment for the detection of major levator ani muscle avulsion in women, when MRI is considered an imperfect reference standard (additional data collection from studies that did not include MRI)
2. To determine the diagnostic accuracy of MRI, transperineal ultrasound, endovaginal ultrasound and vaginal assessment for the detection of any levator ani muscle avulsion (minor or major)
3. To perform subgroup analysis for women with and without symptoms of pelvic floor dysfunction