Does pelvic organ prolapse quantification exam predict urethral mobility in stages 0 and I prolapse?
OBJECTIVE
To determine if women with anterior support stages 0 or I by pelvic organ prolapse quantification (POP-Q) system require Q-tip testing to assess urethral mobility.


METHODS
A prospective study of 134 women presenting for urogynecologic evaluation were examined and assigned stages of anterior wall support according to the POP-Q system. A Q-tip test was performed and urethral hypermobility was defined as a straining angle > or =30 degrees. The Spearman correlation coefficient was used to assess degree of correlation between POP-Q point Aa position and Q-tip values.


RESULTS
The correlation coefficient between point Aa position and Q-tip angle was r = 0.787 (P < 0.001). Urethral hypermobility was noted in 91% of stage I and 100% of stage II-IV patients. The positive predictive value of Q-tip angle > or =30 degrees in stage I-IV prolapse was 99%.


CONCLUSIONS
The POP-Q system is highly predictive of straining urethral angle in all stages of prolapse.
Noblett
Karen
K
Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of California, Irvine-Medical Center, Orange, 92868, USA. knoblett@uci.edu
Lane
Felicia L
FL
Driskill
Christopher S
CS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D010808:Physical Examination; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014521:Urethra / Q000503:physiopathology*; D001743:Urinary Bladder / Q000503:physiopathology; D014549:Urinary Incontinence / Q000175:diagnosis* / Q000503:physiopathology; D014596:Uterine Prolapse / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology