Outcome measures to assess anatomy and function of the posterior vaginal compartment.
OBJECTIVE
Optimal measures for assessing anatomy and defecatory symptoms related to posterior compartment prolapse are unknown. Our objectives were: (1) to test the inter- and intrarater reliability of commonly used or reported anatomic measures of posterior compartment prolapse performed in the clinic setting and under anesthesia; and (2) to examine the correlation between posterior compartment anatomy and defecatory symptoms prior to surgical intervention.


METHODS
A prospective cohort of women with pelvic floor disorders was assessed using a variety of validated questionnaires and standardized examination measures at baseline, at a preoperative visit, and intraoperatively. Inter- and intrarater reliability for anatomic measures were assessed by two separate examiners at the initial visit and repeated by one of the original examiners at a preoperative visit. Reliability was measured using kappa or intraclass correlations according to data type. Symptom and anatomic measure correlations were analyzed using Spearman rank tests.


RESULTS
Mean age of the 120 women recruited was 57 ± 15 years, 49 (41 %) had a point Bp ≥ 0; 59 % reported at least moderate bother from at least one obstructed defecation symptom on the Pelvic Floor Distress Inventory (PFDI). At baseline, most anatomic measures showed at least moderate to good inter/intrarater reliability (> 0.5). There were no moderate or better correlations between any symptom and anatomic measure (all r <  0.27).


CONCLUSIONS
Most anatomic measures of posterior compartment prolapse are reliable and reproducible; however, they do not correlate well with defecatory symptoms.
Division of Gynecologic Surgical Services and Urogynecology, Columbia University Medical Center, 161 Fort Washington Ave, 4th Floor, New York, NY, 10032, USA, clg2173@columbia.edu.
C L
CL
Grimes
J
J
Tan-Kim
C W
CW
Nager
K Y
KY
Dyer
S A
SA
Menefee
G B
GB
Diwadkar
R H
RH
Overholser
R
R
Xu
E S
ES
Lukacz
D000328:Adult; D003248:Constipation / Q000209:etiology; D003672:Defecation / Q000502:physiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D017063:Outcome Assessment, Health Care; D056887:Pelvic Organ Prolapse / Q000473:pathology* / Q000503:physiopathology* / Q000601:surgery; D011446:Prospective Studies; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires