Correlation between anatomical findings and symptoms in women with pelvic organ prolapse using an artificial neural network analysis.
OBJECTIVE
The aim of the present study was to assess the relationship between lower urinary tract symptoms, anatomical findings, and baseline characteristics in women with pelvic organ prolapse (POP).


METHODS
A cross-sectional observational study was performed, enrolling consecutive women seeking cares for lower urinary tract symptoms (LUTS) with evidence of POP. Data regarding baseline characteristics, LUTS, and physical examination were gathered for each patient. Multivariate analysis (multiple linear regression (MLR)) and artificial neural networks (ANNs) were performed to design predicting models.


RESULTS
A total of 1,344 women were included. Age, BMI, pelvic organ prolapse quantification (POP-Q) stage I, and previous surgery for urinary incontinence resulted predictors of urgency and stress incontinence. POP-Q stages III-IV were related to voiding dysfunction and POP symptoms. Age, BMI, and menopausal status resulted predictors for sexual dysfunction. Receiver operating characteristic comparison confirmed that ANNs were more accurate than MLRs in identifying predictors of LUTS.


CONCLUSIONS
LUTS result from a fine interaction between baseline characteristics and anatomical findings. ANNs are valuable instrument for better understanding complex biological models.
Salvatore
Stefano
S
Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Piazza Biroldi 1, 21100 Varese, Italy. stefanosalvatore@hotmail.com
Serati
Maurizio
M
Siesto
Gabriele
G
Cattoni
Elena
E
Zanirato
Mara
M
Torella
Marco
M
D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D016571:Neural Networks, Computer; D017773:Pelvic Floor / Q000473:pathology*; D056887:Pelvic Organ Prolapse / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000473:pathology; D014555:Urination Disorders / Q000209:etiology* / Q000473:pathology