title: Posterior vaginal wall defects and their relation to measures of pelvic floor neuromuscular function and posterior compartment symptoms.
abstract: OBJECTIVE
  The purpose of this study was to describe the pelvic floor neuromuscular function and posterior compartment symptoms in patients with posterior vaginal wall prolapse.
  
  
  METHODS
  Two hundred twenty-seven women who were referred to a urogynecology and urology clinic were enrolled prospectively. Each patient completed a health history questionnaire and standardized physical examination that specifically graded uterovaginal prolapse according to the pelvic organ prolapse quantification system.
  
  
  RESULTS
  Sixty-nine women had a pelvic organ prolapse quantification system point (most dependent portion of the posterior vaginal wall during straining as measured from the hymeneal ring) of < or =-1. Older age, a history of hysterectomy, a genital hiatus of >3 cm (48% vs 24%; P =.002), and perineal descent of > or =2 cm (14% vs 5%; P =.042) were significantly more common in women with posterior vaginal prolapse. When women with posterior prolapse and symptomatic complaints were compared with asymptomatic women with prolapse, a perineal descent of > or =2 cm (21% vs 0%; P =.004) was significantly more common in the symptomatic group.
  
  
  CONCLUSIONS
  Pelvic floor neuromuscular function should be related to posterior vaginal prolapse and symptoms; however, only perineal descent appears associated strongly with both symptoms and prolapse in this population.
authors.affiliation: Department of Obstetrics and Gynecology, University of Washington, Seattle, USA.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Fialkow
authors.forename: Carolyn
authors.initials: C
authors.lastname: Gardella
authors.forename: Jennifer
authors.initials: J
authors.lastname: Melville
authors.forename: Gretchen M
authors.initials: GM
authors.lastname: Lentz
authors.forename: Dee E
authors.initials: DE
authors.lastname: Fenner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009132:Muscles / Q000294:innervation* / Q000503:physiopathology*; D017773:Pelvic Floor / Q000503:physiopathology*; D010502:Perineum / Q000503:physiopathology*; D017698:Postmenopause; D012907:Smoking; D014596:Uterine Prolapse / Q000453:epidemiology / Q000503:physiopathology*