The role of pelvic floor ultrasound correlated with pelvic organ prolapse quantification in the assessment of anterior and apical compartments of pelvic organ prolapse

Abstract

Background Pelvic organ prolapse (POP) is a gynecological disease significantly associated with older age. A higher prevalence of women with symptomatic POP showed physical and emotional distress, negatively affecting their quality of life (QoL). The most widespread tool used is the prolapse quantification system (POP-Q) of the International Continence Society (ICS). The aim of this study was to evaluate the role of ultrasound (U/S) compared to POP-Q for the detection and quantification of POP in the anterior (urinary bladder) and apical (cervix/vaginal vault) compartments of the pelvic floor in Egyptian women. Results The current study revealed that among 83 women, 53 had POP with a mean age of 50.83 years, 96.2% had anterior compartment prolapse (either alone or with apical compartment prolapse), 52% had apical compartment prolapse (either alone or with anterior compartment prolapse), 47.2% had anterior compartment prolapse only, and 3.7% had apical compartment prolapse only. There was a strong agreement (almost linear) between (POP-Q) and U/S in detecting significant pelvic organ prolapse in the anterior compartment (Kappa value 0.925, P < 0.001) and the apical compartment (Kappa value 0.945 and P < 0.001). With higher value of sensitivity and specificity, our study assigned significant anterior compartment prolapse using a cutoff value of 0 for point Ba of POP-Q and −11.5 for bladder neck descent at valsalva using U/S. Conclusions Pelvic floor ultrasound provides general and detailed anatomical overview of the pelvic floor as well as detection and assessment of the POP in anterior and middle compartments.