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Updated: Sep 24, 2025

Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse POP Quantification System
Published on: September 20, 2018
The Relationship Between Perineal Body Size, Total Vaginal Length, Apical Prolapse, and Prolapse Symptoms
Tugba Kinay1, Omer Lutfi Tapisiz2, Sadiman Kiykac Altinbas2
1From the Department of Obstetrics and Gynecology, University of Health Sciences Turkey, Etlik Zubeyde Hanim Women's Health Training and Research Hospital.
This study found that total vaginal length (TVL) and genital hiatus size (GH) are key indicators for diagnosing apical prolapse. While GH, C, and Ba points correlate with symptoms, perineal body (PB) and TVL do not.
Area of Science:
- Urogynecology and Pelvic Floor Disorders
- Female Pelvic Medicine and Reconstructive Surgery
- Anatomical Measurements in Pelvic Organ Prolapse
Background:
- Apical prolapse diagnosis traditionally relies on specific Pelvic Organ Prolapse Quantification (POP-Q) points (C and D).
- The utility of other POP-Q measurements and anatomical features for diagnosing apical prolapse and its associated symptoms remains incompletely understood.
Purpose of the Study:
- To investigate the association between perineal body size (PB), total vaginal length (TVL), and apical prolapse.
- To evaluate the relationship between these anatomical measurements and apical prolapse symptoms.
- To explore the correlation of other POP-Q measurements with apical prolapse and its symptoms.
Main Methods:
- A cross-sectional study involving 200 women (100 with apical prolapse, 100 without).
- Evaluation of perineal body size (PB) and total vaginal length (TVL) in relation to apical prolapse.
- Secondary analysis of other POP-Q measurements (including C, D, Ba, and genital hiatus size - GH) for association with apical prolapse and symptoms.
Main Results:
- Total vaginal length (TVL ≤8 cm) and genital hiatus size (GH >4.5 cm) showed significant association with apical prolapse.
- Perineal body (PB) measurements had lower sensitivity and specificity for diagnosing apical prolapse.
- Genital hiatus size (GH >4.8 cm), C point (>-5.8 cm), and Ba point (>-1.1 cm) were significantly associated with prolapse symptoms, unlike PB and TVL.
Conclusions:
- Total vaginal length (TVL) and genital hiatus size (GH) are more strongly associated with apical prolapse than perineal body (PB) size.
- Genital hiatus size (GH), C, and Ba points are linked to prolapse symptoms, whereas PB and TVL are not.
- These findings suggest specific POP-Q measurements are more valuable for diagnosing apical prolapse and its symptoms than previously assumed.
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