Pelvic organ prolapse symptoms in relation to POPQ, ordinal stages and ultrasound prolapse assessment

Kirsten B Kluivers, Jan C M Hendriks, Clara Shek, Hans Peter Dietz, Kirsten B Kluivers, Jan C M Hendriks, Clara Shek, Hans Peter Dietz

Abstract

Adequate staging of pelvic organ prolapse is important in clinical practice and research. The ability of the POPQ, ordinal stages and ultrasound prolapse assessment were evaluated for their ability to discriminate between women with and without prolapse symptoms. The leading edge of the predominant compartment in the three assessment systems was used for the calculation of receiver operating characteristics curves. Two hundred and sixty five (265) consecutive women were evaluated. The area under the receiver operating characteristics curve for the three staging systems ranged from 0.715 to 0.783. POPQ staging and ordinal staging performed equally well in the prediction of prolapse symptoms (p = 0.780), and both performed better as compared with ultrasound prolapse assessment (p = 0.048 and p = 0.015, respectively). Prolapse staging can equally be performed by the POPQ and ordinal stages systems as far as the discrimination between women with and without prolapse symptoms is concerned. The ultrasound prolapse assessment does not perform better as compared with these two systems.

Figures

Fig. 1
Fig. 1
Receiver operating characteristics curves representing the ability of the POPQ (dotted line), the ordinal stages (solid line) and ultrasound prolapse assessment (broken line) to predict prolapse symptoms. For reference the x = y line is shown. The stars indicate the cut-off point in each staging system, using the principle of equal costs of misclassification. This refers to the hymen (0 cm) in the POPQ, stage 2 in the ordinal stages and 14 mm below the reference line through the symphysis pubis in ultrasound prolapse assessment

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Source: PubMed

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