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Defining normal apical vaginal support: a relook at the POSST study.

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  • 1Division of Urogynecology and Reconstructive Pelvic Surgery, University of North Carolina at Chapel Hill, 3032 Old Clinic Bldg., CB# 7570, Chapel Hill, NC, 27599-7570, USA. radhika_patnam@med.unc.edu.

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|June 18, 2018
PubMed
Summary

This study establishes normal Pelvic Organ Prolapse Quantification (POP-Q) values for apical points C and D, and total vaginal length (TVL) in asymptomatic women. These findings provide a crucial reference for diagnosing pelvic organ prolapse.

Keywords:
Apical supportPelvic organ prolapse support

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Area of Science:

  • Urogynecology
  • Female pelvic medicine
  • Anatomical measurements

Background:

  • Pelvic Organ Prolapse Quantification (POP-Q) is a standard method for staging pelvic organ prolapse (POP).
  • Establishing normative data for POP-Q points in asymptomatic women is essential for accurate diagnosis.
  • Previous studies have not definitively established reference values for apical POP-Q points and total vaginal length (TVL).

Purpose of the Study:

  • To reanalyze the 2005 Pelvic Organ Support Study (POSST) dataset.
  • To define normal values for apical POP-Q points C and D in asymptomatic women.
  • To determine normal total vaginal length (TVL) in asymptomatic women.

Main Methods:

  • Retrospective observational data-set review of 1011 women aged >18 years.
  • Data collected from six US centers included demographics, prolapse symptoms, and POP-Q measurements.
  • Mean and standard deviation calculated for POP-Q points C and D, and TVL.

Main Results:

  • 948 women were included after exclusion criteria were applied.
  • Mean age was 42 ± 14 years; population included white, black, and Hispanic women.
  • Mean POP-Q values: Point C (vaginal cuff) -7.3 ± 1.5 cm, Point C (cervix) -5.9 ± 1.5 cm, Point D -8.7 ± 1.5 cm.
  • Mean TVL: 9.8 ± 1.3 cm (no hysterectomy), 8.9 ± 1.5 cm (hysterectomy).

Conclusions:

  • This study provides reference values for normal apical POP-Q points and TVL.
  • These values are derived from a large cohort of women undergoing annual gynecological exams.
  • The findings aid in the clinical assessment and diagnosis of pelvic organ prolapse.