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Title

Agreement of Ultrasound Measures with POP-Q in Patients with Pelvic Organ Prolapse (WOMEN’ S IMAGING)

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Abstract

 Background: Ultrasound has emerged as a valuable complimentary tool for assessment of Pelvic Organ Prolapse (POP). Objectives: The present study aimed to evaluate the correlation between ultrasound measures and clinical staging in patients with suspected POP. Patients and Methods: Forty women with clinical suspicion of POP were enrolled in this cross-sectional study between November 2011 and April 2012. Pelvic Organ Prolapse quantification (POP-Q) system was used for clinical staging. Perineal ultrasound was performed both at rest and during Valsalva maneuver after proper preparation. On mid sagittal view, two reference lines were drawn; midpelvic line (MPL) was defined as the inferior horizontal tangent of symphysis pubis and H line was drawn from the most inferior part of symphysis pubis to the anorectal junction. Spearman’ s correlation coefficient and Kappa coefficient of Agreements were used for statistical analysis. Results: Forty women with the mean age of 49. 9  10. 07 years were enrolled. Excellent correlation was seen between MPL and H line (rho = 0. 91, 0. 93 and 0. 88 in anterior, apical and posterior compartments, respectively). POP-Q had good-to-excellent correlation with ultrasound (rho = 0. 84, 0. 78 and 0. 63 forHline and rho = 0. 89, 0. 82, 0. 71 for MPL in anterior, apical and posterior compartments respectively). In anterior and apical compartments, high Agreement was seen between clinical and ultrasound staging methods when grouping patients to no prolapse/mild vs. moderate/severe. In the posterior compartment, this Agreement was significant when grouping was done based on the presence or absence of POP. Conclusion: Ultrasound has high correlation with POP-Q staging in all compartments for staging of Pelvic Organ Prolapse. Ultrasound might be useful in the diagnosis of pop in those with negative clinical examination.

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