DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20171534

Pelvic organ prolapse quantification system: to valsalva or not to valsalva while measuring genital hiatus (GH) and perineal body (PB)

Tapaswini Hota, Sujata Misra

Abstract


Background: It is a study to determine whether or not, the widening of GH and PB with valsalva is evidence of pelvic floor dysfunction, and by the logic should the values in POPQ staging, be taken at valsalva or at rest.

Methods: Prospective 2 arm cohort study. However, the analysis of various risk factors for prolapse was done in a case control study manner.

Results: As compared to women without prolapse, in patients with POP, the dimensions of GH and PB are higher. Also, the increase in their dimensions with valsalva is more in prolapse cases. So valsalving while measurement of GH and PB would give a better idea of pelvic floor dysfunction.

Conclusions: The study shows association between the severity of urinary problems and degree of prolapse. Measurements of POPQ when taken during valsalva, tend to give a better picture of levator dysfunction in prolapse patients.


Keywords


Calibrated swab stick, Genital hiatus, Pelvic organ prolapse quantification, Perineal body, Quality of life

Full Text:

PDF

References


Bump RC, Mattiason A, Bo K, Brubaker LP, DeLancey JO, Klarskov P et al. The standardization of terminology of female pelvic organ prolapsed and pelvic floor dysfunction. AJOG. 1996;175:10-7.

Visco AG, Wie JT, Mcclure LA, HandaVL. Effects of examination technique modification on POPQ results. Int Urogyn J. 14:136-40.

Mant J, Painter R, Vessey M. Epidemiology of genital prolapsed :observations from the Oxford Family Planning Association study. Br J Obstet Gyncaecol. 1997;104:579-85.

Samuelsson EC, Victor FTA, Tibblin G, Svardsudd KF. Signs of genital prolapsed in Swedish population of women 20 to 59 years of years of age and possible related factors. Am J Obstet Gynecol. 1999;180:299-305.

Swift SE. The distribution of pelvic organ support in a population of female subjects seen for routine gynaecologic health care. Am J Obstet Gyncol. 2000;183:277-85.

Progetto Menopausa Italia Study Group. Risk factors for genital prolapsed in non-hysterectomized women around menopause. The results from a large cross sectional study in menopausal clinics in Italy. Eur J Obstet Gyncol Reproduc Biol. 2000;93:125-40.

Oslen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gyncol. 1997;89:501-6.

Rinne KM, Kirkinen PP. What predisposes young women to genital prolapsed? Eur J Obstet Gyncol Reprod Biol. 1999;84:23-5.

Snooks SJ, Swash M, Henry MM, Setchel M. Risk factors in childbirth causing damage to pelvic floor innervations. Int J Colorectal Dis. 1986;1:20-4.

Gilpin SA, Gosling JA, Smith ARB. The pathogenesis of genitourinary prolapsed and stress incontinence of urine. A histochemical study. Br J Obstet Gyn. 1989;96:15-23.

Smith ARB, Hosker GL, Warrell DW. The role of partial dennervation in the etiology of prolapse and SUI, A Neurophysiogic study. Br J Obstet Gyncol. 1989;96:24-8.

Jones PN, Lubowski DZ, Swash M, Henry MM. Relation between perineal descent and pudendal nerve damage in idiopathic fecal incontinence. Int J Colorectal Dis. 1987;2:93-5.

Lubowski DZ, Swash M, Nichols J, Henry MM. Increases pudendal nerve terminal motot latency with defecation straining. Br J Surg. 1988;75:1095-7.

Spence Jones C, Kamm MA, Henry MM, Hudson CN. Bowel dysfunction: A pathogenic factor in uterovaginal prolapse and urinary stresss incontinence. Br J Obstet Gyncol. 1994;101:147-52.

Davis GD. Uterine prolapsed after laparoscopic uterosacral transaction in nulliparous trainees: a report of three cases. J Reprod Med .1996;41:279-82.

Khunda A, Shek KL, Dietz HP. Can Ballooning of levator hiatus be determined clinically? Am J Obstet Gyncol. 2012;206:246.e1-4.

Visco AG, Wei JT, McClure LA, Handa VL, Nygaard IE. Effects of examining technique modifications on pelvic organ prolapsed quantification (POP-Q) results. Int Urogynecol J Pelvic Floor Dysfunct. 2003;14(2):136-40.

Khunda A, Shek KL, Dietz HP. Can Ballooning of the levator hiatus be determined clinically? Am J Obstet Gynecol. 2012;206:246.e1-4.