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Updated: Jun 16, 2026
Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse (POP) Quantification System
Published on: September 20, 2018
Feasibility, inter- and intra-rater reliability of physiotherapists measuring prolapse using the pelvic organ
Diane Stark1, Philippa Dall, Mohamed Abdel-Fattah
1Physiotherapy Department, Obstetrics and Gynaecology, Southern General Hospital, Glasgow, UK. diane.stark@nhs.net
Introduction And Hypothesis:
There is no agreed assessment tool for physiotherapists treating pelvic organ prolapse. This study hypothesised that pelvic organ prolapse quantification (POP-Q) assessment was a feasible measure for use by physiotherapists and tested inter- and intra-rater agreement.
Methods:
Six physiotherapists and two gynaecologists participated. Women were recruited from uro/gynaecology clinics. Two POP-Q examinations were performed at the first clinic (gynaecologist, physiotherapist 1) and 1 week later (physiotherapist 1, physiotherapist 2). The examination was timed and women completed a short questionnaire. Using weighted kappa, agreement of POP-Q stage was assessed.
Results:
Forty-five women were recruited (median age 59, range 32-87 years). Agreement between gynaecologist and physiotherapist was substantial (weighted kappa = 0.63). Weighted kappa was 0.67 for inter-rater agreement between two different physiotherapists and 0.71 for intra-rater reliability for the same physiotherapist. Examination time was significantly shorter (difference 53 +/- 73 s, p < 0.001) for gynaecologists. Participants found the examination acceptable.
Conclusions:
POP-Q is a feasible and reliable outcome measure for physiotherapists to use.
