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Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse POP Quantification System
Published on: September 20, 2018
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Does preoperative resting genital hiatus size predict surgical outcomes?
Payton Schmidt1, Caroline K Cox1, John O DeLancey1
1Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA.
The Journal of Obstetrics and Gynaecology Research
|August 19, 2021
Summary
Preoperative genital hiatus did not predict pelvic organ prolapse recurrence after surgery. However, higher Point Bp measurements were associated with increased recurrence risk, indicating its predictive value for prolapse outcomes.
Area of Science:
- Urogynecology
- Pelvic Floor Reconstructive Surgery
Background:
- Pelvic organ prolapse (POP) recurrence remains a challenge after surgical repair.
- Identifying predictive factors for POP recurrence is crucial for optimizing surgical outcomes and patient counseling.
Purpose of the Study:
- To investigate the association between preoperative genital hiatus at rest and medium-term prolapse recurrence.
- To evaluate the predictive value of preoperative genital hiatus compared to other metrics like Point Bp.
Main Methods:
- Retrospective analysis of 165 women undergoing native tissue prolapse surgery (2002-2017).
- Pelvic organ prolapse quantification (POP-Q) data, including genital hiatus and Point Bp, were assessed preoperatively, at 6 weeks, and ≥1 year postoperatively.
- Prolapse recurrence defined by anatomic outcomes or retreatment; logistic regression used for analysis.
Main Results:
- No significant difference in preoperative genital hiatus at rest between women with and without prolapse recurrence (3.5 cm vs 3.5 cm, p=0.71).
- Preoperative Point Bp was independently associated with prolapse recurrence (OR 1.24, p=0.01).
- Women undergoing colpoperineorrhaphy had significantly larger preoperative genital hiatus measurements.
Conclusions:
- Preoperative genital hiatus at rest is not a reliable predictor of medium-term prolapse recurrence, particularly in patients undergoing colpoperineorrhaphy.
- Preoperative Point Bp is a stronger predictor of short-term prolapse recurrence, with each 1 cm increase associated with a 24% higher odds of recurrence.
