title: The association between different measures of pelvic floor muscle function and female pelvic organ prolapse.
abstract: OBJECTIVE
  We aimed to compare palpatory and translabial ultrasound (TLUS) measurements of pelvic floor muscle (PFM) function with symptoms and signs of female pelvic organ prolapse (FPOP) to determine a possible association.
  
  
  METHODS
  We analysed data from 726 women with a mean age of 56 (SD 13.7, range 18-88) years, seen for symptoms of pelvic floor dysfunction between August 2011 and April 2013. The examination included a standardised interview and clinical assessment of FPOP with Pelvic Organ Prolapse Quantification (POP-Q) measurements, Modified Oxford Scale (MOS) grading and 4D TLUS.
  
  
  RESULTS
  Symptoms of prolapse were reported in 51.4% (373 out of 726) with a mean bother score of 5.8 (SD 2.91, range 0-10). A clinically significant POP (Incontinence Society [ICS]-POP-Q stage ≥ 2) in any compartment was diagnosed in 77.1%. Mean MOS was 2.4 (SD 1.1, range 0-5). Significant POP on TLUS was seen in 54.6% (389 out of 712). TLUS volumes at rest and on maximal PFM contraction were analysed on a desktop PC, to assess the degree of bladder neck (BN) cranioventral shift and levator antero-posterior (AP) diameter reduction, blinded against other data. Mean cranioventral BN shift was 7.11 (SD 4.36, range 0.32-25.32) mm and mean levator AP diameter reduction was 8.6 (SD 4.8, range 0.3-31.3) mm. MOS was strongly associated with subjective and objective POP (P ≤ 0.001), whereas this was not true for TLUS measurements of tissue displacement.
  
  
  CONCLUSIONS
  The MOS seems to be a more valid measure of PFM function than sonographically determined BN displacement or reduction of hiatal AP diameter observed on PFM contraction.
authors.affiliation: Department of Gynecology, Oslo University Hospital, Ulleval, Pb 4956, Nydalen, Oslo, Norway. sisseloversand@gmail.com.|Institute of Clinical Medicine, University of Oslo, Oslo, Norway. sisseloversand@gmail.com.
authors.forename: Sissel H
authors.initials: SH
authors.lastname: Oversand
authors.affiliation: Department of Obstetrics and Gynecology, Sydney Medical School Nepean, University of Sydney, Penrith, Australia.|University of Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Ixora Kamisan
authors.initials: IK
authors.lastname: Atan
authors.affiliation: Department of Obstetrics and Gynecology, Sydney Medical School Nepean, University of Sydney, Penrith, Australia.|University of Western Sydney, Liverpool, Sydney, Australia.
authors.forename: Ka Lai
authors.initials: KL
authors.lastname: Shek
authors.affiliation: Department of Obstetrics and Gynecology, Sydney Medical School Nepean, University of Sydney, Penrith, Australia.
authors.forename: Hans Peter
authors.initials: HP
authors.lastname: Dietz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D010173:Palpation; D017773:Pelvic Floor / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*; D056887:Pelvic Organ Prolapse / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014463:Ultrasonography; D055815:Young Adult
keywords: Pelvic floor muscle function; Pelvic organ prolapse; Translabial ultrasound