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Updated: Aug 17, 2026

Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse (POP) Quantification System
Published on: September 20, 2018
Pelvic organ descent and symptoms of pelvic floor disorders
Chiara Ghetti1, W Thomas Gregory, S Renee Edwards
1Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, USA.
Objective:
This study evaluates the relationship between symptoms of pelvic floor disorders, and measurement of pelvic organ prolapse.
Study Design:
This retrospective cross-sectional study assessed prolapse in 905 women in an academic urogynecologic practice using the Pelvic Organ Prolapse Quantification exam. Symptoms were assessed with a Likert symptom questionnaire and the Urogenital Distress Inventory. Relationships between symptoms and prolapse were analyzed using Spearman's correlation.
Results:
Symptoms of "bulging" correlated moderately to the greatest extent of prolapse (r=0.4, P<.001). Frequency of bother progressively increases when the leading edge descends from -3 and 0. Between +1 and +5, 90% of women report bother. Symptoms typically attributed to anterior or posterior wall prolapse did not correlate with descent of the respective compartment.
Conclusion:
"Bulging" is the principle symptom that correlates with prolapse severity. We found no discrete anatomic position that discriminates between prolapse as a disease state and normal anatomic variation.
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