Skip to main content
Top
Published in: International Urogynecology Journal 5/2009

Open Access 01-05-2009 | Original Article

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

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

Published in: International Urogynecology Journal | Issue 5/2009

Login to get access

Abstract

Introduction and hypothesis

This study evaluates the agreement in prolapse staging between clinical examination, dynamic magnetic resonance (MR), imaging and perineal ultrasonography.

Methods

Anatomical landmarks in the anterior, central, and posterior compartment were assessed in relation to three reference lines on dynamic MR imaging and one reference line on dynamic ultrasonography. These measurements were compared to the according POP-Q measurements. Agreement between the three methods was analyzed with Spearman’s rank correlation coefficient (r s) and Bland and Altman plots.

Results

Correlations were good to moderate in the anterior compartment (r s range = 0.49; 0.70) and moderate to poor (r s range = −0.03; 0.49) in the central and posterior compartment. This finding was independent of the staging method and reference lines used.

Conclusion

Pelvic organ prolapse staging with the use of POP-Q, dynamic MR imaging, and perineal ultrasonography only correlates in the anterior compartment.
Literature
1.
go back to reference Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, Shull BL, Smith AR (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17PubMedCrossRef Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, Shull BL, Smith AR (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17PubMedCrossRef
2.
go back to reference Altman D, Lopez A, Kierkegaard J, Zetterstrom J, Falconer C, Pollack J, Mellgren A (2005) Assessment of posterior vaginal wall prolapse: comparison of physical findings to cystodefecoperitoneography. Int Urogynecol J Pelvic Floor Dysfunct 16:96–103PubMedCrossRef Altman D, Lopez A, Kierkegaard J, Zetterstrom J, Falconer C, Pollack J, Mellgren A (2005) Assessment of posterior vaginal wall prolapse: comparison of physical findings to cystodefecoperitoneography. Int Urogynecol J Pelvic Floor Dysfunct 16:96–103PubMedCrossRef
3.
go back to reference Altringer WE, Saclarides TJ, Dominguez JM, Brubaker LT, Smith CS (1995) Four-contrast defecography: pelvic “floor-oscopy”. Dis Colon Rectum 38:695–699PubMedCrossRef Altringer WE, Saclarides TJ, Dominguez JM, Brubaker LT, Smith CS (1995) Four-contrast defecography: pelvic “floor-oscopy”. Dis Colon Rectum 38:695–699PubMedCrossRef
4.
go back to reference Hock D, Lombard R, Jehaes C, Markiewicz S, Penders L, Fontaine F, Cusumano G, Nelissen G (1993) Colpocystodefecography. Dis Colon Rectum 36:1015–1021PubMedCrossRef Hock D, Lombard R, Jehaes C, Markiewicz S, Penders L, Fontaine F, Cusumano G, Nelissen G (1993) Colpocystodefecography. Dis Colon Rectum 36:1015–1021PubMedCrossRef
5.
go back to reference Kelvin FM, Maglinte DD, Hornback JA, Benson JT (1992) Pelvic prolapse: assessment with evacuation proctography (defecography). Radiology 184:547–551PubMed Kelvin FM, Maglinte DD, Hornback JA, Benson JT (1992) Pelvic prolapse: assessment with evacuation proctography (defecography). Radiology 184:547–551PubMed
6.
go back to reference Cortes E, Reid WM, Singh K, Berger L (2004) Clinical examination and dynamic magnetic resonance imaging in vaginal vault prolapse. Obstet Gynecol 103:41–46PubMed Cortes E, Reid WM, Singh K, Berger L (2004) Clinical examination and dynamic magnetic resonance imaging in vaginal vault prolapse. Obstet Gynecol 103:41–46PubMed
7.
go back to reference Fauconnier A, Zareski E, Abichedid J, Bader G, Falissard B, Fritel X (2007) Dynamic magnetic resonance imaging for grading pelvic organ prolapse according to the international continence society classification: which line should be used. Neurourol Urodyn 27:191–197CrossRef Fauconnier A, Zareski E, Abichedid J, Bader G, Falissard B, Fritel X (2007) Dynamic magnetic resonance imaging for grading pelvic organ prolapse according to the international continence society classification: which line should be used. Neurourol Urodyn 27:191–197CrossRef
8.
go back to reference Lienemann A, Sprenger D, Janssen U, Grosch E, Pellengahr C, Anthuber C (2004) Assessment of pelvic organ descent by use of functional cine-MRI: which reference line should be used. Neurourol Urodyn 23:33–37PubMedCrossRef Lienemann A, Sprenger D, Janssen U, Grosch E, Pellengahr C, Anthuber C (2004) Assessment of pelvic organ descent by use of functional cine-MRI: which reference line should be used. Neurourol Urodyn 23:33–37PubMedCrossRef
9.
go back to reference Singh K, Reid WM, Berger LA (2001) Assessment and grading of pelvic organ prolapse by use of dynamic magnetic resonance imaging. Am J Obstet Gynecol 185:71–77PubMedCrossRef Singh K, Reid WM, Berger LA (2001) Assessment and grading of pelvic organ prolapse by use of dynamic magnetic resonance imaging. Am J Obstet Gynecol 185:71–77PubMedCrossRef
10.
go back to reference Dietz HP, Haylen BT, Broome J (2001) Ultrasound in the quantification of female pelvic organ prolapse. Ultrasound Obstet Gynecol 18:511–514PubMedCrossRef Dietz HP, Haylen BT, Broome J (2001) Ultrasound in the quantification of female pelvic organ prolapse. Ultrasound Obstet Gynecol 18:511–514PubMedCrossRef
11.
go back to reference Morren GL, Balasingam AG, Wells JE, Hunter AM, Coates RH, Perry RE (2005) Triphasic MRI of pelvic organ descent: sources of measurement error. Eur J Radiol 54:276–283PubMedCrossRef Morren GL, Balasingam AG, Wells JE, Hunter AM, Coates RH, Perry RE (2005) Triphasic MRI of pelvic organ descent: sources of measurement error. Eur J Radiol 54:276–283PubMedCrossRef
12.
go back to reference Barbaric ZL, Marumoto AK, Raz S (2001) Magnetic resonance imaging of the perineum and pelvic floor. Top Magn Reson Imaging 12:83–92PubMedCrossRef Barbaric ZL, Marumoto AK, Raz S (2001) Magnetic resonance imaging of the perineum and pelvic floor. Top Magn Reson Imaging 12:83–92PubMedCrossRef
13.
go back to reference Dietz HP (2004) Ultrasound imaging of the pelvic floor. Part II: three-dimensional or volume imaging. Ultrasound Obstet Gynecol 23:615–625PubMedCrossRef Dietz HP (2004) Ultrasound imaging of the pelvic floor. Part II: three-dimensional or volume imaging. Ultrasound Obstet Gynecol 23:615–625PubMedCrossRef
14.
go back to reference Kluivers KB, Hendriks JC, Shek C, Dietz HP (2008) Pelvic organ prolapse symptoms in relation to POPQ, ordinal stages and ultrasound prolapse assessment. Int Urogynecol J Pelvic Floor Dysfunct 19:1299–1302PubMedCrossRef Kluivers KB, Hendriks JC, Shek C, Dietz HP (2008) Pelvic organ prolapse symptoms in relation to POPQ, ordinal stages and ultrasound prolapse assessment. Int Urogynecol J Pelvic Floor Dysfunct 19:1299–1302PubMedCrossRef
15.
go back to reference Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310PubMed Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310PubMed
16.
go back to reference Hall AF, Theofrastous JP, Cundiff GW, Harris RL, Hamilton LF, Swift SE, Bump RC (1996) 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 175:1467–1470PubMedCrossRef Hall AF, Theofrastous JP, Cundiff GW, Harris RL, Hamilton LF, Swift SE, Bump RC (1996) 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 175:1467–1470PubMedCrossRef
17.
go back to reference Broekhuis SR, Kluivers KB, Hendriks JCM, Vierhout ME, Barentsz JO, Fütterer JJ (2009) Dynamic magnetic resonance imaging: reliability of anatomical landmarks and reference lines used to assess pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 20(2):141–148PubMedCrossRef Broekhuis SR, Kluivers KB, Hendriks JCM, Vierhout ME, Barentsz JO, Fütterer JJ (2009) Dynamic magnetic resonance imaging: reliability of anatomical landmarks and reference lines used to assess pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 20(2):141–148PubMedCrossRef
18.
go back to reference Braekken IH, Majida M, Ellstrom-Engh M, Dietz HP, Umek W, Bo K (2008) Test–retest and intra-observer repeatability of two-, three- and four-dimensional perineal ultrasound of pelvic floor muscle anatomy and function. Int Urogynecol J Pelvic Floor Dysfunct 19:227–235PubMedCrossRef Braekken IH, Majida M, Ellstrom-Engh M, Dietz HP, Umek W, Bo K (2008) Test–retest and intra-observer repeatability of two-, three- and four-dimensional perineal ultrasound of pelvic floor muscle anatomy and function. Int Urogynecol J Pelvic Floor Dysfunct 19:227–235PubMedCrossRef
Metadata
Title
POP-Q, dynamic MR imaging, and perineal ultrasonography: do they agree in the quantification of female pelvic organ prolapse?
Authors
Suzan R. Broekhuis
Kirsten B. Kluivers
Jan C. M. Hendriks
Jurgen J. Fütterer
Jelle O. Barentsz
Mark E. Vierhout
Publication date
01-05-2009
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 5/2009
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-009-0821-1

Other articles of this Issue 5/2009

International Urogynecology Journal 5/2009 Go to the issue