Pelvic Organ Support Study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects.
OBJECTIVE
The purpose of this study was to describe the distribution of pelvic organ support in a gynecologic clinic population to define the clinical disease state of pelvic organ prolapse and to analyze its epidemiologic condition.


METHODS
This was a multicenter observational study. Subjects who were seen at outpatient gynecology clinics who required an annual gynecologic examination underwent a pelvic organ prolapse quantification examination and completed a prolapse symptom questionnaire. Receiver operator characteristic curves were used to define pelvic organ prolapse with the use of symptoms and pelvic organ prolapse quantification examination measures. Standard age-adjusted univariate and multivariate logistic regression analysis were used to evaluate various relationships.


RESULTS
The population consisted of 1004 women who were aged 18 to 83 years. The prevalence of pelvic organ prolapse quantification stages was 24% (stage 0), 38% (stage 1), 35% (stage 2), and 2% (stage 3). The definition of pelvic organ prolapse that was determined by the receiver operator characteristic curve was the leading edge of their vaginal wall that was -0.5 cm above the hymenal remnants. Multivariate analysis revealed age, Hispanic race, increasing body mass index, and the increasing weight of the vaginally delivered fetus as risk factors for pelvic organ prolapse, as defined in this population.


CONCLUSIONS
The results from this population suggest that there is a bell-shaped distribution of pelvic organ support in a gynecologic clinic population. Advancing age, Hispanic race, increasing body mass index, and the increasing weight of the vaginally delivered fetus have the strongest correlations with prolapse.
Swift
Steven
S
Department of Obstetrics and Gynecology, Divison of Benign Gynecology, Medical University of South Carolina, Charleston, SC, USA.
Woodman
Patrick
P
O'Boyle
Amy
A
Kahn
Margie
M
Valley
Michael
M
Bland
Deirdre
D
Wang
Wei
W
Schaffer
Joe
J
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001724:Birth Weight; D015992:Body Mass Index; D005006:Ethnicity; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D015995:Prevalence; D011391:Prolapse; D012372:ROC Curve; D012005:Rectal Prolapse / Q000453:epidemiology*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000453:epidemiology*; D014596:Uterine Prolapse / Q000453:epidemiology*