Severity of pelvic organ prolapse associated with measurements of pelvic floor function

This study tested the hypothesis that clinical measurements of the superficial perineum and of pelvic floor muscle (PFM) function correlate with the severity of pelvic organ prolapse. This retrospective cross-sectional study assessed 1037 women in an academic urogynecologic practice. Greatest descent of prolapse, by the Pelvic Organ Prolapse Quantification system, was correlated with two assessments of levator function--the Oxford grading scale and levator hiatus (LH) size measured by digital examination. Correlations were calculated using Pearson's correlation for continuous variables and Kendall's tau-b. Severity of prolapse correlated moderately with genital hiatus (GH) (r = 0.5, p<0.0001) and with LH (transverse r = 0.4, p < 0.0001; longitudinal r = 0.5, p < 0.0001), but weakly with the Oxford grading scale (r = -0.16, p < 0.0001). LH correlated with GH (r = 0.5, p < 0.0001) but not with perineal body (r = 0.06, p = 0.06). Both GH and LH size are associated with the severity of prolapse. LH size correlates more strongly to prolapse severity than assessment of PFM function by the Oxford grading scale.