DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20172356

Evaluation of pelvic organ prolapse by standardized POP Q system for vaginal hysterectomy

Vandana Dhama, Rachna Chaudhary, Shakun Singh, Manisha Singh

Abstract


Background: Uterovaginal prolapse is a common condition affecting women in reproductive and perimenopausal age groups. Evaluating pelvic organ prolapse in an objective, reproducible, easy to apply method is required for proper management. Aim of the study was preoperative and postoperative evaluation of pelvic organ prolapse by POP Q system in patients undergoing vaginal hysterectomy.

Methods: In this observational study, 100 patients having pelvic organ prolapse, (average age 48±12 years), underwent elective vaginal hysterectomy at Lala Lajpat Rai Memorial Medical College Meerut during June 2015 to July 2016. POP Q was done preoperatively and after completion of surgery by the same surgeon.

Results: The mean of genital hiatus preoperatively was 6.4 and post operatively it was 3.64 i.e. the genital hiatus was reduced by 2.76. The mean of total vaginal length pre-operatively was 8.07 and post operatively was 7.2. There was only 0.9 cm reduction in the vaginal length. The mean of perineal body pre-operatively was 2.64 and post operatively was 3.64. The points preoperatively were Aa 2.35, Ba 2.61, C 2.57, Ap 2.24, Bp 0.96, D-4.79 and post-operative the value of the points was -2.19, -2.04,-5.57,-2.98,-2.52 respectively and D point absent due to hysterectomy.

Conclusions: The post-operative POP Q was analysed and the patients having grade 0 were 63 (optimum anatomical outcome) and patients having grade 1 were 36 (satisfactory anatomical outcome).


Keywords


Pelvic organ prolapse, POP Q, Vaginal hysterectomy

Full Text:

PDF

References


Swift SE, Tae SB. Correlation of symptoms with degree of pelvic organ support in a general population of women: What is pelvic organ prolapse? Am J Obstet Gynecol. 2003;189:372-9.

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

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

Bump RC, Mattiasson A, Bo K, Brubaker LP. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;175(1):10-17.

Swift S. Validation of a simplified technique for using the POPQ pelvic organ prolapse classification system . Int Urogynecol J. 2006;17:615-20.

Hoffman B, Schorge J, Schaffer J. Pelvic organ prolapse, Williams gynaecology 2nd ed. 2012;644.

Seo JT, Kim JM. Pelvic organ support and prevalence by Pelvic Organ Prolapse-Quantification (POP-Q) in Korean women. J Urol. 2006;175(5):1769-72.

Yuvaraj TP, Mahale AR. Assessment of prolapse by Pelvic Organ Prolapse Quantification (POP Q) System. Indian J Basic Appl Med Res. 2014;3:324-30.

Awotunde OT, Fehintola AO, Ogunlaja OA, Olujide LO, Aaron OI, Bakare B et al. An audit of uterovaginal prolapse in Ogbomoso, south-west Nigeria. Res J Health Sci. 2016;4(1):31-6.

Abrams P, Cardozo L. The standardisation of terminology of lower urinary tract function: Report from the Standardisation Subcomitee of International Continence Society. Am J Obstret Gynecol. 2002;187:116-26.

Bump RC. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction . Am J Obstret Gynecol. 1996;175:10-7.

Hall AF, Theofrastous JP, Cundiff GW, Harris RL, Hamilton LF, Swift SE et al. Interobserver and intraobserver reliability of the proposed International Continence Society, Society of Gynecologic Surgeons, and American Urogynecologic Society pelvic organ prolapse classification system. Am J Obstet Gynecol. 1996;175(6):1467-70.