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Is there a pelvic organ prolapse threshold that predicts pelvic floor symptoms?

Abstract：

OBJECTIVE:The objective of this study was to determine the minimum threshold level at which maximum anatomic prolapse predicts bothersome pelvic floor symptoms. STUDY DESIGN:We performed a cross-sectional study of women older than 40 years undergoing gynecologic and urogynecologic examinations using Pelvic Organ Prolapse Quantification (POP-Q) examinations to assess support and Pelvic Floor Distress Inventory questionnaires to assess symptoms. Across the spectrum of prolapse severity, we calculated receiver operating characteristic (ROC) curves and areas under the curves (AUCs) for each symptom. RESULTS:Of 296 participants, age was 56.3 +/- 11.2 years, and 233 (79%) were white. POP-Q stage was 0 in 39 (13%), 1 in 136 (46%), 2 in 89 (30%), and 3 in 33 (11%). ROC analysis for each symptom revealed an AUC of 0.89 for bulging/protrusion; 0.81 for splinting to void; 0.55-0.62 for other prolapse and urinary symptoms; and 0.48-0.56 for bowel symptoms. Using a threshold of 0.5 cm distal to the hymen, the sensitivity (69%) and specificity (97%) were high for protrusion symptoms but poor for most other symptoms considered. CONCLUSION:Vaginal descensus 0.5 cm distal to the hymen accurately predicts bulging/protrusion symptoms; however, we could not identify a threshold of prolapse severity that predicted other pelvic floor symptoms.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

Gutman RE,Ford DE,Quiroz LH,Shippey SH,Handa VL

doi

10.1016/j.ajog.2008.07.028

subject

Has Abstract

pub_date

2008-12-01 00:00:00

pages

683.e1-7

issue

6

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(08)00809-0

journal_volume

199

pub_type

杂志文章

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