POP-Q, dynamic MR imaging, and perineal ultrasonography: do they agree in the quantification of female pelvic organ prolapse?

Broekhuis, Suzan R.; Kluivers, Kirsten B.; Hendriks, Jan C.M.; Fütterer, Jurgen J.; Barentsz, Jelle O.; Vierhout, Mark E.

doi:10.1007/s00192-009-0821-1

Cited by 59 publications

(48 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…18 scans (11.4%) were not analysable (17 of poor quality in the POP group and 1 missing in the control group). The mean age was 49.5 years [standard deviation (SD), 14 Enterocoele on two-dimensional transperineal ultrasound measuring 12 mm below reference line (solid horizontal line refers to the reference line parallel to postero-inferior margin of symphysis pubis and arrow marked E measures the enterocoele perpendicular to the reference line). AC, anal canal; B, bladder; E, enterocoele; P, probe; R, rectum; SP, symphysis pubis; U, urethra.…”

Section: Resultsmentioning

confidence: 99%

“…The patients were scanned in the supine position and without using any rectal or vaginal contrast. 9,14 PFUS consisted of two-dimensional (2D) transperineal ultrasound (TPUS) and high-frequency 2D/three-dimensional (3D) endovaginal ultrasound (EVUS). TPUS was performed with the patient placed in the dorsal lithotomy, with the hips flexed and abducted.…”

Section: Methodsmentioning

confidence: 99%

“…In order to avoid false-negative results and to allow full development of pelvic organ descent, the transducer was gently positioned on the perineum. 9,14 The measurements of prolapse on the image were taken offline demonstrating maximum descent. A reference line was drawn parallel to the inferoposterior margin of the symphysis pubis, 14 perpendicular to which the leading edge of descent was measured in millimetres ( Figure 1).…”

Section: Methodsmentioning

confidence: 99%

“…9,14 The measurements of prolapse on the image were taken offline demonstrating maximum descent. A reference line was drawn parallel to the inferoposterior margin of the symphysis pubis, 14 perpendicular to which the leading edge of descent was measured in millimetres ( Figure 1). The sonographical definition of a clinically significant cystocele and rectocele (15 and 10 mm below the reference line, respectively) 15 and 10 mm below the reference line for middle compartment prolapse were used.…”

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

The value of pre-operative multicompartment pelvic floor ultrasonography: a 1-year prospective study

Lone¹,

Sultan²,

Stankiewicz³

et al. 2014

BJR

View full text Add to dashboard Cite

Objective: Comprehensive assessment of the pelvic floor (PF) provides information and diagnoses of coexisting abnormalities that may affect operative decisions. Our aim was to establish if pre-operative PF ultrasonography (PFUS) in patients complaining of PF dysfunction can complement clinical findings and contribute to additional management strategies. Methods: Females were recruited from the urogynaecology/ gynaecology clinics between July and October 2009 and underwent pelvic organ prolapse quantification (POPQ) by an independent examiner. PFUS was performed using two-dimensional (2D) transperineal ultrasound (TPUS), high-frequency 2D/three-dimensional (3D) endovaginal ultrasound (EVUS) using a biplane probe with linear and transverse arrays and a 360°r otational 3D-EVUS. The clinician performing PFUS was blinded to POPQ results. POPQ and PFUS were repeated at 1 year. Two clinicians analysed the scans independently.Results: 158 of 160 females had a POPQ and PFUS. 105 females had pelvic organ prolapse and/or incontinence and 53 asymptomatic females were controls. 26 additional ultrasound diagnoses were noted at baseline and 46 at 1 year using 2D-TPUS and EVUS. Only one female with additional diagnoses on PFUS needed surgical intervention for this condition. Conclusion: Multicompartment PFUS identifies additional conditions to that diagnosed on clinical assessment. However, it neither changes the initial surgical management nor the management at 1-year follow-up and therefore clinical assessment should not be substituted by PFUS. Advances in knowledge: PFUS can be helpful in providing additional information; however, it does not change the initial management of the patient and therefore should not replace clinical assessment.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

The value of pre-operative multicompartment pelvic floor ultrasonography: a 1-year prospective study

Lone¹,

Sultan²,

Stankiewicz³

et al. 2014

BJR

View full text Add to dashboard Cite

show abstract

“…This finding was independent of the staging method and reference lines used. 9 Study by Etlik O et al showed physical examination and MR findings were very concordant in the diagnosis of pelvic prolapse and statistical correlations in the stages of prolapse were established between both of the methods (P<0.01 for anterior and middle comportment, P<0.05 for posterior comportment. 10 Similar study by Deval et al showed intra-operative findings were considered the gold standard against which physical examination, dynamic colpocystodefecography and MRI were compared.…”

Section: Discussionmentioning

confidence: 95%

MR imaging evaluation for the assessment of pelvic organ prolapse: a newer technique

Dave

Joshi

Goel

et al. 2017

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Background: MRI is the newest technique used to evaluate patients with pelvic floor disorders. It allows relatively non-invasive, dynamic evaluation of all pelvic organs in multiple planes and can directly visualize the muscular and ligamentous pelvic floor support structures. Using MRI to evaluate pelvic floor disorders may be most helpful in patients with multicompartment findings or symptoms, posterior compartment abnormalities, severe prolapse, or recurrent pelvic floor symptoms after prior surgical repair. MRI is often able to reveal more extensive organ prolapse than physical examination alone.Methods: The present study was carried out in the Department of Radiodiagnosis and Obstetrics and Gynecology of Mahatma Gandhi Memorial Medical College and M.Y. Hospital, Indore, Madhya Pradesh from November 2014 to October 2015. A total of 43 patients who had symptoms of pelvic floor dysfunction like uterine prolapse, urinary or rectal dysfunction were evaluated by high resolution USG. Patients with low lying uterus on USG were subjected to MRI. Before MRI, these patients were assessed by a Gynecologist, and a clinical diagnosis in form of the organ/organs prolapsed and the grade of individual prolapse was assigned and tabled in the prefixed format.Results: Prolapse is more common in patients with greater than 50 years age (63% patients). MRI picked up more lesions compared to clinical examination, 90% as compared to 82.5% on clinical examination. MRI has good correlation with surgery in diagnosing prolapse. Concomitant prolapse of the Anterior and Middle compartment is the most common clinical entity diagnosed on 52.5% patients in our set up. MRI has poor sensitivity in identifying posterior compartment prolapse. There is good agreement between the clinical grading and MRI grading (81.8% correlation).Conclusions: T MRI offers a novel approach of simultaneous imaging of all compartments of the female pelvis at a single setting. With lesser intraobserver variation and better visualization of the pelvic anatomy MRI would help in accurate staging and hence better outcomes in patients in terms of symptom relief.

show abstract

Value of pelvic examination in women with pelvic organ prolapse: A systematic review

Pizzoferrato,

Sallée,

Thubert

et al. 2024

Intl J Gynecology & Obste

View full text Add to dashboard Cite

BackgroundRecent recommendations from the French High Authority of Health on pelvic organ prolapse (POP) management underline the value of a pelvic examination.ObjectivesThe aim of this paper was to analyze the literature and identify the best evidence available regarding pelvic examination for women presenting prolapse‐associated symptoms in terms of diagnosis and predictability of treatment success.Search StrategyThe databases were queried similarly using Medical Subject Headings (MeSH) and non‐MeSH terms broadly related to pelvic examination and POP management.Selection CriteriaWe included studies assessing the diagnostic contribution of pelvic examination (correlation with symptoms) and its value for assessing the risk of pessary failure or recurrence after reconstructive surgery.Data Collection and AnalysisWe assessed peer‐reviewed articles on PubMed, Embase, and Cochrane database up to May 2023. The methodological quality of all the included studies was assessed using the ROBINS‐E or RoB2 tools.Main ResultsIn all, 67 studies were retained for the review. Prolapse‐associated symptoms are poorly correlated with POP diagnosis. The symptom that is best correlated with the POP stage is the presence of a vaginal bulge (moderate to good correlation). The factors most strongly associated with the risk of recurrence after surgery or pessary failure are clinical: essentially a higher POP stage before surgery, levator ani muscle avulsion, and vaginal and genital measurements.ConclusionsIn women complaining of prolapse‐associated symptoms, a pelvic examination (vaginal speculum and digital vaginal examination) can confirm the presence of POP and identify risk factors for treatment failure or recurrence after surgical management or pessary placement. A higher stage of POP and levator ani muscle avulsion—discernible on pelvic examination—are major risk factors for POP recurrence or treatment failure. These features must be taken into account in the treatment choice and discussed with the patient.

show abstract

POP-Q, dynamic MR imaging, and perineal ultrasonography: do they agree in the quantification of female pelvic organ prolapse?

Cited by 59 publications

References 20 publications

The value of pre-operative multicompartment pelvic floor ultrasonography: a 1-year prospective study

The value of pre-operative multicompartment pelvic floor ultrasonography: a 1-year prospective study

MR imaging evaluation for the assessment of pelvic organ prolapse: a newer technique

Value of pelvic examination in women with pelvic organ prolapse: A systematic review

Contact Info

Product

Resources

About