Diagnosis of urethral diverticulum mimicking pelvic organ prolapse with translabial ultrasonography

Lee, Sa Ra; Lim, Young Mee; Jeon, Ji Hyun; Park, Mi Hye

doi:10.1016/j.ajog.2017.06.026

Cited by 5 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many conditions, including various vaginal masses such as urethral diverticulum, vaginal leiomyoma, or urogenital cysts, can be confusing factors that mimic POP. A patient with a protruding vaginal mass suggestive of an anterior compartment prolapse with symptoms of urinary frequency and dyspareunia was revealed to have a urethral diverticulum on TLUS [ 10 ]. Braga et al reported a patient who complained of vaginal bulging and overactive bladder symptoms with POP-Q stage II anterior vaginal prolapse (Ba:0), and the histopathological examination revealed an anterior vaginal leiomyoma [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Importance of Translabial Ultrasound for the Diagnosis of Pelvic Organ Prolapse and Its Correlation with the POP-Q Examination: Analysis of 363 Cases

Nam

Lee

Kim

et al. 2021

JCM

Self Cite

View full text Add to dashboard Cite

The incidence of pelvic organ prolapse (POP) is increasing in our aging society. We aimed to evaluate the clinical usefulness of translabial ultrasound (TLUS) by comparing the findings of POP-Q examination and TLUS in advanced POP patients and we also aimed to evaluate the prevalence of rectocele and enterocele on the TLUS. We analyzed the TLUS and POP-Q exam findings of 363 symptomatic POP patients who visited our clinic from March 2019 to April 2021. We excluded three patients who had conditions mimicking POP, as revealed by the TLUS. The most common POP type was anterior compartment POP (68.61%), followed by apical compartment (38.61%) and posterior compartment (16.11%) POP. Agreement between the POP-Q exam and TLUS was tested using Cohen’s kappa (κ). p values < 0.05 were considered statistically significant. The incidence of rectocele or enterocele was only 1.67% (6/360) and there was no rectocele or enterocele in most patients (246/252, 96.63%) when the POP-Q exam revealed posterior compartment POP, suggesting that they only had posterior vaginal wall relaxation. The positive predictive value of the POP-Q exam for detecting rectocele or enterocele (as revealed by TLUS) was only 2.38%, whereas the negative predictive value was 100%. In conclusion, the application of TLUS is useful in the diagnosis of POP, especially for differentiation of true POP from conditions mimicking POP. The correlation between the POP-Q exam and TLUS is low, especially in posterior compartment POP, and therefore, patients with POP-Q exam findings suggesting posterior compartment POP should undergo TLUS to check for rectocele or enterocele. The use of TLUS in the diagnosis of POP patients can improve the accuracy of the diagnosis of POP patients in conjunction with a POP-Q exam.

show abstract

Section: Discussionmentioning

confidence: 99%

“…In addition, we cannot exactly know which organ is in the prolapsed vaginal pouch, and there can also be both pelvic organs and/or a mass. Many conditions mimicking POP, sometimes called false POP, have been reported [ 8 , 9 , 10 ] ( Figure 1 ).…”

Section: Introductionmentioning

confidence: 99%

Importance of Translabial Ultrasound for the Diagnosis of Pelvic Organ Prolapse and Its Correlation with the POP-Q Examination: Analysis of 363 Cases

Nam

Lee

Kim

et al. 2021

JCM

Self Cite

View full text Add to dashboard Cite

show abstract

“…The diagnosis of an anterior compartment prolapse can be aided with the addition of TLUS to a POP-Q exam. For example, a vaginal mass, such as a urethral diverticulum or a vaginal leiomyoma, can be a confusing factor that mimics POP [ 6 ]. Braga et al [ 30 ] reported a patient with stage-II anterior vaginal prolapse using the POP-Q staging system, although the final diagnosis revealed a vaginal leiomyoma.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the presence or absence of a rectocele and an enterocele is not clearly determined by the POP-Q stage [ 3 ]. Rarely, a vaginal mass mimicking prolapse can also be misdiagnosed as POP [ 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Although posterior vaginal prolapse has been considered a synonym of a rectocele, recent studies have shown that true rectoceles are only observed in 2.38–39% of women [ 3 , 4 , 5 , 6 , 7 ]. However, we cannot distinguish between simple posterior vaginal wall relaxation, a true rectocele, and an enterocele using only the POP-Q examination ( Figure 1 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A New Angle Measurement in Translabial Ultrasound as an Adjunct for the Diagnosis of Pelvic Organ Prolapse

2022

Self Cite

View full text Add to dashboard Cite

The aim of this study was to compare the data obtained by a pelvic organ prolapse quantification (POP-Q) examination with the translabial ultrasound (TLUS) quantification of prolapse, using a new method of angle measurement. We analyzed the TLUS and POP-Q exam findings of 452 patients with symptoms of POP. The POP-Q system was used for clinical staging. TLUS was performed both at rest, and during the Valsalva maneuver after proper preparation. A horizontal reference line was drawn through the inferior margin of the symphysis pubis and the levator plate connected to the rectal ampulla, and the difference was calculated between the rest and the Valsalva maneuver. The Spearman’s correlation coefficient of agreement between the TLUS and the clinical POP-Q staging was used for statistical analysis. There was a weak degree of correlation between the POP-Q findings for the Ap parameter and our new angle measurement (rho = 0.17, p < 0.001). Thus, POP staging in conjunction with TLUS with this new angle measurement shows better agreement for the diagnosis of POP than POP-Q staging alone.

show abstract

The use of tomographic ultrasound imaging on three-dimensional translabial ultrasound: a diagnostic sign for urethral diverticulum

2019

View full text Add to dashboard Cite

Diagnosis of urethral diverticulum mimicking pelvic organ prolapse with translabial ultrasonography

Cited by 5 publications

References 0 publications

Importance of Translabial Ultrasound for the Diagnosis of Pelvic Organ Prolapse and Its Correlation with the POP-Q Examination: Analysis of 363 Cases

Importance of Translabial Ultrasound for the Diagnosis of Pelvic Organ Prolapse and Its Correlation with the POP-Q Examination: Analysis of 363 Cases

A New Angle Measurement in Translabial Ultrasound as an Adjunct for the Diagnosis of Pelvic Organ Prolapse

The use of tomographic ultrasound imaging on three-dimensional translabial ultrasound: a diagnostic sign for urethral diverticulum

Contact Info

Product

Resources

About