title: The effect of bladder fullness on evaluation of pelvic organ prolapse.
abstract: OBJECTIVE
  To investigate the effect of bladder fullness on pelvic organ prolapse (POP) staging via the Pelvic Organ Prolapse Quantification System (POP-Q).
  
  
  METHODS
  Sixty women with advanced POP underwent pelvic examination with maximal Valsalva straining via POP-Q with an empty bladder and after transcatheter bladder filling to maximum cystometric capacity, with simultaneous intra-abdominal and intravesical pressure recordings. Main outcome measures included POP-Q values and staging with full versus empty bladder.
  
  
  RESULTS
  An empty bladder was associated with a significantly higher POP-Q staging (median, 3 vs 2; P<0.0001); and a lower location of points Ba (4.51 vs 1.37; P<0.0001), Aa (2.58 vs 0.62; P<0.0001), Bp (-0.68 vs -1.10; P=0.01), Ap (0.83 vs -1.27; P=0.002), C (1.57 vs -1.07; P<0.0001), and D (0.14 vs -2.77; P<0.0001) compared with a full bladder. However, genital hiatus, perineal body, and total vaginal length values were not significantly affected by bladder fullness. No differences in intra-abdominal or detrusor pressures were noted between empty and full bladder states.
  
  
  CONCLUSIONS
  POP-Q assessment with a full bladder is associated with underestimation of POP severity. Therefore, bladder emptying should be a standard requirement for POP-Q staging and reporting.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery, Carmel Medical Center, Technion University, Rappaport Faculty of Medicine, Haifa, Israel.
authors.forename: Nir
authors.initials: N
authors.lastname: Haya
authors.forename: Eran
authors.initials: E
authors.lastname: Segev
authors.forename: Grace
authors.initials: G
authors.lastname: Younes
authors.forename: Eyal
authors.initials: E
authors.lastname: Goldschmidt
authors.forename: Ron
authors.initials: R
authors.lastname: Auslender
authors.forename: Yoram
authors.initials: Y
authors.lastname: Abramov
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D056887:Pelvic Organ Prolapse / Q000473:pathology*; D011446:Prospective Studies; D012720:Severity of Illness Index; D001743:Urinary Bladder; D014546:Urinary Catheterization