Distribution of pelvic organ support measures in a population-based sample of middle-aged, community-dwelling African American and white women in southeastern Michigan

Trowbridge, Elisa R.; Fultz, Nancy H.; Patel, Divya; DeLancey, John O.L.; Fenner, Dee E.

doi:10.1016/j.ajog.2008.01.054

Cited by 60 publications

(36 citation statements)

References 9 publications

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“…We understand that this reasoning increases the percentage of "asymptomatic" women with disease from 3% [16] to 37-69.8% [4] based solely on an anatomic landmark. Yet this anatomic threshold (-1) recognizes the contribution of pregnancy and vaginal delivery on pelvic support in multiparous women [2,4].…”

Section: Discussionmentioning

confidence: 99%

“…Yet this anatomic threshold (-1) recognizes the contribution of pregnancy and vaginal delivery on pelvic support in multiparous women [2,4]. Furthermore, we believe that this anatomic threshold Kassis 13 does have utility for assessment of surgical outcome after prolapse repair.…”

Section: Discussionmentioning

confidence: 99%

“…Pelvic organ prolapse and surgical success after reconstructive surgery have evolved from a physician centered to a patient centered diagnosis based on clinical data from welldesigned epidemiologic studies [1][2][3][4]. Two of the more commonly used classification systems;…”

Section: Introductionmentioning

confidence: 99%

“…Yet 37% of asymptomatic women (17% hysterectomized, median parity 2) have Stage II prolapse suggesting incredibly high disease prevalence if these anatomic definitions are considered valid [2]. However, physical examination of nulliparous women reveals vaginal descent no greater than 1.46 cm above the hymen (< Stage II prolapse) [4] suggesting that pregnancy, multiparity, and hysterectomy may contribute to pelvic support defects in asymptomatic women regardless of the definition of prolapse or surgical success after reconstructive surgery [8]. Nonetheless, vaginal symptoms including the feeling of a vaginal bulge are the most reliable symptom of pelvic organ prolapse when the leading edge descends to or beyond the hymen [9].…”

Section: Introductionmentioning

confidence: 99%

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If you could see what we see, would it bother you?

et al. 2016

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Objective: The purpose of our study is to determine if the anatomic threshold for pelvic organ prolapse diagnosis and surgical success remains valid when the patient sees what we see on exam.Methods: 200 participants were assigned, by computer generated block randomization, to see one of 4 videos. Each video contained the same six clips representative of various degrees of anterior vaginal wall support. Participants were asked questions immediately after each clip.They were asked: "In your opinion, does this patient have a bulge or something falling out that she can see or feel in the vaginal area". Similarly, they were asked to give their opinion on surgical outcome on a 4-point Likert scale. Results:The proportion of participants who identified the presence of a vaginal bulge increased substantially at the level of early Stage 2 prolapse (1 cm above the hymen), with 67% answering yes to the question regarding bulge. The proportion of participants who felt that surgical outcome was less desirable also increased substantially at early Stage 2 prolapse (1 cm above the hymen), with 52% describing that outcome as "not at all" or "somewhat" successful. Conclusion:Early Stage 2 pelvic organ prolapse (1 cm above the hymen) is the anatomic threshold at which women identify both a vaginal bulge and a less desirable surgical outcomewhen they see what we see on examination.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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If you could see what we see, would it bother you?

et al. 2016

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“…[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Women who develop symptoms may present with a single symptom such as feeling a vaginal bulge or pelvic pressure, or they may present with a combination of symptoms. 23 Loss of normal vaginal support occurs in most women with advancing age, particularly if they have had children.…”

Section: How Do Women With Pelvic Organ Prolapse Present?mentioning

confidence: 99%

Pelvic organ prolapse

Barber

2016

BMJ

148

108

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Self-perceived natural history of pelvic organ prolapse described by women presenting for treatment

et al. 2009

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Introduction and Hypothesis To describe the self-perceived natural history of pelvic organ prolapse (POP) in women seeking care. Methods Women presenting to a university-based urogynecology clinic for POP (N=107) completed a questionnaire including questions about how and when their prolapse was discovered. A urogynecologic examination including the Pelvic Organ Prolapse Quantification (POP-Q) was also performed. Results Forty eight percent of these women sought medical attention “immediately” after discovering a bulge. The median time to seek care was 4 months (range 1 month to 45 years). Twenty-six percent associated their prolapse with a specific event (e.g. moving furniture, pushing a car). POP was self-discovered by 76% (81/107) of women. Self-discovered prolapses were larger than those diagnosed by physicians (Ba +1.3 cm vs. 0.1cm, p=0.03 respectively). Conclusions Women seek medical advice within months of discovering their prolapse. Self-discovery is associated with higher stage prolapse than prolapse diagnosed by health care providers.

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Distribution of pelvic organ support measures in a population-based sample of middle-aged, community-dwelling African American and white women in southeastern Michigan

Cited by 60 publications

References 9 publications

If you could see what we see, would it bother you?

If you could see what we see, would it bother you?

Pelvic organ prolapse

Self-perceived natural history of pelvic organ prolapse described by women presenting for treatment

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