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Updated: Jan 9, 2026
Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse POP Quantification System
Published on: September 20, 2018
Sarcopenia as a Predictor of Pelvic Organ Prolapse in Women: A Retrospective Study Using the Psoas-Lumbar Vertebral
Sinharib Citgez1, Kadir Can Sahin2, Feyyaz Irmak1
1Department of Urology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Cerrahpasa, Turkey.
Introduction:
Pelvic organ prolapse (POP) is a prevalent condition among older women, often linked to weakened pelvic floor muscles. Sarcopenia, characterized by age-related loss of muscle mass and function, may contribute to the pathophysiology of POP. However, the association between sarcopenia and POP remains unclear. This study aims to investigate the relationship between sarcopenia and POP using the psoas-lumbar vertebral index (PLVI) as an objective, practical, imaging-based assessment.
Materials And Methods:
A retrospective analysis was conducted on patients who presented to the functional urology outpatient clinic between March 2022 and March 2024. Patients were categorized into two groups: those with severe POP requiring surgical intervention and those without POP. PLVI was measured using computed tomography (CT) scans at the L4 vertebral level. Demographic data, and clinical characteristics results were compared between groups. Logistic regression models assessed predictors of POP, testing linearity of PLVI using restricted cubic splines. Model discrimination, calibration, and clinical utility were evaluated by receiver operating characteristic (ROC) analysis, Hosmer-Lemeshow test, and decision-curve analysis. A sensitivity analysis restricted to CTs ≤ 3 months was also performed.
Results:
A total of 112 patients were analyzed (64 with POP, 48 controls). PLVI values were significantly lower in the POP group (p = 0.021). In multivariable analysis, previous pelvic surgery (OR 0.53, p = 0.011), positive provocative stress test (OR: 4.73, p < 0.001), and lower PLVI (OR: 0.18, p = 0.032) were independently associated with POP. The model showed acceptable calibration (Hosmer-Lemeshow χ² = 15.97, p = 0.06) and moderate discrimination (AUC = 0.627, 95% CI: 0.522-0.733). Sensitivity analysis yielded consistent results.
Conclusion:
This study highlights a significant association between sarcopenia, as measured by PLVI, and POP. PLVI offers an objective, easily accessible, imaging-based metric for sarcopenia evaluation in patients with POP. Given these findings, incorporating sarcopenia assessment into POP management may enhance clinical decision-making and optimize patient outcomes with multidisciplinary approach.
Clinical Trial Registration:
Since our study is a retrospective data analysis, clinical trial registration is not required.
