The Standardization of Terminology of Female Pelvic Organ Prolapse and Pelvic Floor Dysfunction

Bump, Richard C.; Mattiasson, Anders; Bø, Kari; Brubaker, Linda; DeLancey, John O.L.; Klarskov, Peter; Shull, Bobby L.; Smith, Anthony J.

doi:10.3109/9781439807217-113

Cited by 760 publications

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“…The severity of prolapse was determined preoperatively and postoperatively using the POP-Q system [17]. Grade II prolapse was diagnosed preoperatively in 47.1 % (136/289) of patients; 49.8 % (144/289) of patients had grade III prolapse, and 3.1 % (9/289) of patients had grade IV prolapse.…”

Section: Anatomical Resultsmentioning

confidence: 99%

“…The anatomical results were assessed using the POP-Q sys- tem [17]. Patientsʼ quality of life was recorded using the Prolapse Quality-of-Life (P-QoL) questionnaire [18,19].…”

Section: Patients and Study Designmentioning

confidence: 99%

“…This system, which is now considered the standard international classification for prolapse surgery, was published by the ICS in 1996 [17]. It assesses the location of the defective structures and quantifies the severity of the prolapse.…”

Section: Anatomical Outcomementioning

confidence: 99%

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Quality of Life, Sexuality, Anatomical Results and Side-effects of Implantation of an Alloplastic Mesh for Cystocele Correction at Follow-up after 36 Months

Fünfgeld¹,

Stehle²,

Henne

et al. 2017

Geburtshilfe Frauenheilkd

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ABSTR AC TIntroduction Pelvic organ prolapse can significantly reduce quality of life of affected women, with many cases requiring corrective surgery. The rate of recurrence is relatively high after conventional prolapse surgery. In recent years, alloplastic meshes have increasingly been implanted to stabilize the pelvic floor, which has led to considerable improvement of anatomical results. But the potential for mesh-induced risks has led to a controversial discussion on the use of surgical meshes in urogynecology. The impact of cystocele correction and implantation of an alloplastic mesh on patientsʼ quality of life/sexuality and the long-term stability of this approach were investigated. MethodIn a large prospective multicenter study, 289 patients with symptomatic cystocele underwent surgery with implantation of a titanized polypropylene mesh (TiLOOP ® Total 6, pfm medical ag) and followed up for 36 months. Both primary procedures and procedures for recurrence were included in the study. Anatomical outcomes were quantified using the POP-Q system. Quality of life including sexuality were assessed using the German version of the validated P-QoL questionnaire. All adverse events were assessed by an independent clinical event committee.Results Mean patient age was 67 ± 8 years. Quality of life improved significantly over the course of the study in all investigated areas, including sexuality and personal relationships (p < 0.001, Wilcoxon test). The number of adverse events which occurred in the period between 12 and 36 months after surgery was low, with just 22 events reported. The recurrence rate for the anterior compartment was 4.5 %. Previous or concomitant hysterectomy increased the risk of recurrence in the posterior compartment 2.8-fold and increased the risk of erosion 2.25-fold.Conclusion Cystocele correction using a 2nd generation alloplastic mesh achieved good anatomical and functional results in cases requiring stabilization of the pelvic floor and in patients with recurrence. The rate of recurrence was low, the patientsʼ quality of life improved significantly, and the risks were acceptable. . The most serious effect of pelvic organ prolapse is impairment of bladder and bowel function accompanied by incontinence and voiding disorders [2,3]. General well-being, personal relationships, particularly sexuality [4], and physical and social activities often suffer from the effects of prolapse [5,6]. The incidence of pelvic organ prolapse in women has increased in parallel with the general increase in life expectancy, and the likelihood that women aged 80 years will require surgical intervention (e.g. hysterectomy, pelvic floor reconstruction) is 12.2 % [7]. One in nine women is affected by prolapse [8]. Up to 30 % of patients require a repeat operation for recurrence within 5 years of the original procedure [9][10][11][12]. Surgical correction of prolapse should not just reposition the prolapsed pelvic organs, it should also restore the patientʼs quality of life or at least improve it. As the recurrence rate...

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Section: Anatomical Resultsmentioning

confidence: 99%

“…The anatomical results were assessed using the POP-Q sys- tem [17]. Patientsʼ quality of life was recorded using the Prolapse Quality-of-Life (P-QoL) questionnaire [18,19].…”

Section: Patients and Study Designmentioning

confidence: 99%

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Quality of Life, Sexuality, Anatomical Results and Side-effects of Implantation of an Alloplastic Mesh for Cystocele Correction at Follow-up after 36 Months

Fünfgeld¹,

Stehle²,

Henne

et al. 2017

Geburtshilfe Frauenheilkd

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“…In 1996, the International Continence Society defined a system of Pelvic Organ Prolapse Quantification (POPQ). 4 Demonstrating high intra and inter-examiner reliability, the POPQ system is a major advance in studying prolapse. It allows researchers to report findings in a standardized, easily reproducible fashion.…”

Section: Methodsmentioning

confidence: 99%

Mesh repair of vaginal wall prolapse

Kapur

Dalal²

2014

Medical Journal Armed Forces India

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Perigee ProlapseMesh repair a b s t r a c t Background: Over the last decade, mesh augmented surgical repair is being increasingly used in pelvic organ prolapse. Perigee and Apogee are comprehensive, single-use needle suspension kits that provide a standardized delivery method for mesh or graft-augmented repairs. This study has been carried out to study the safety and efficacy of the Perigee and Apogee mesh repair systems.Methods: 10 cases of posterior vaginal wall prolapse with or without Apical prolapse underwent Apogee mesh repair surgery and 10 cases of anterior vaginal wall prolapse underwent Perigee mesh repair surgery. Depending on the findings either Apogee or Perigee or both were used. Patients were followed up for complications of the surgery if any, and for the relief of the symptoms related to prolapse and associated symptoms of bowel/ bladder dysfunction. Objective cure rate was prolapse < stage 1 as per the POPQ system. Data collected was statistically analyzed.Results: The objective and subjective cure rates were 100%. Postoperative complications were minor. No patient developed de novo urinary urge symptoms, stress urinary incontinence or UTI postoperatively. There were no operative complications like bladder injuries, hematoma and rectal injuries. The mean blood loss was 180 ml and the mean duration of surgery during the Apogee and Perigee mesh repair was 51.5 AE 2.99 min and 60.9 AE 4.65 min respectively. Conclusion:In the present study there was a significant improvement in the degree of prolapse after the mesh repair surgeries and the results were consistent even at 12 months follow up.ª 2013, Armed Forces Medical Services (AFMS). All rights reserved.

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“…Pelvic organ prolapse was assessed in both the lithotomy position and standing with the patient exerting a maximal Valsalva manoeuvre using the pelvic organ prolapse quantification (POPQ) system [14]. The participants then underwent multichannel urodynamics according to the ICS recommendations [15].…”

Section: Methodsmentioning

confidence: 99%

Can we predict detrusor overactivity in women with lower urinary tract symptoms? The King's Detrusor Overactivity Score (KiDOS)

Giarenis

Musonda

Mastoroudes

et al. 2016

European Journal of Obstetrics & Gynecology and Reproductiv

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A prediction model is able to predict detrusor overactivity more accurately than a symptomatic diagnosis alone, in women with lower urinary tract symptoms. Abstract ObjectiveTraditionally, urodynamic studies (UDS) have been used to assess lower urinary tract symptoms (LUTS), but their routine use is now discouraged. While urodynamic stress incontinence is strongly associated with the symptom of stress urinary incontinence (SUI) and a positive cough test, there is a weak relationship between symptoms of overactive bladder and detrusor overactivity (DO). The aim of our study was to develop a model to predict DO in women with LUTS. Study DesignThis prospective study included consecutive women with LUTS attending a urodynamic clinic. All women underwent a comprehensive clinical and urodynamic assessment. The effect of each variable on the odds of DO was estimated both by univariate analysis and adjusted analysis using logistic regression. Results1006 women with LUTS were included in the study with 374 patients (37%) diagnosed with DO. The factors considered to be the best predictors of DO were urgency urinary incontinence, urge rating/void and parity (p-value <0.01). The absence of SUI, vaginal Page 3 of 26 A c c e p t e d M a n u s c r i p t 3 bulging and previous continence surgery were also good predictors of DO (p-value < 0.01).We have created a prediction model for DO based on our best predictors. In our scoring system, presence of UUI scores 5; mean urge rating/void ≥ 3 scores 3; parity ≥ 2 scores 2; previous continence surgery scores -1; presence of SUI scores -1; and the complaint of vaginal bulging scores -1. If a criterion is absent, then the score is 0 and the total score can vary from a value of -3 to +10. The Receiver Operating Characteristic (ROC) analysis for the overall cut-off points revealed an area under the curve of 0.748 (95%CI 0.741, 0.755). ConclusionThis model is able to predict DO more accurately than a symptomatic diagnosis alone, in women with LUTS. The introduction of this scoring system as a screening tool into clinical practice may reduce the need for expensive and invasive tests to diagnose DO, but cannot replace UDS completely.

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The Standardization of Terminology of Female Pelvic Organ Prolapse and Pelvic Floor Dysfunction

Cited by 760 publications

References 0 publications

Quality of Life, Sexuality, Anatomical Results and Side-effects of Implantation of an Alloplastic Mesh for Cystocele Correction at Follow-up after 36 Months

Quality of Life, Sexuality, Anatomical Results and Side-effects of Implantation of an Alloplastic Mesh for Cystocele Correction at Follow-up after 36 Months

Mesh repair of vaginal wall prolapse

Can we predict detrusor overactivity in women with lower urinary tract symptoms? The King's Detrusor Overactivity Score (KiDOS)

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