title: A new method for the evaluation of pelvic organ prolapse in women using a three-dimensional optic scanner.
abstract: OBJECTIVE
  Modern classifications of pelvic floor movements are based on pelvic floor assessment in a static midsagittal plane. This study presents a new and potentially useful 3D noninvasive tool for studying pelvic floor mobility in women with pelvic organ prolapse (POP).
  
  
  METHODS
  Thirty-four patients with POP [grade ≥3 using the Pelvic Organ Prolapse Quantification (POP-Q) system] and 30 healthy volunteers (controls) at rest and during Valsalva maneuver were scanned using an Artec™ 3D optic portable scanner and 3D pelvic floor models were generated. We calculated the volume of the prolapsed vaginal wall using dynamic prolapse increment (DPI), which is defined as an increase in prolapse volume from rest to its maximal Valsalva probe [DPI = (Vval - Vrest) / Vrest %)].
  
  
  RESULTS
  In the control group, the average DPI was 28 % (16-51 %). As the DPI in patients with POP varied widely, two subgroups were identified. In the first subgroup, the average DPI was 290 % (125-437 %), whereas it was only 48.8 % (41-55 %) in the second subgroup. Prolapse volume in subgroup 1 was not due to the most prominent component of POP but was induced by enlargement of the prolapsed vaginal wall from other components, such as a cystocele or enterocele, which was evident only during the 3D procedure and could not be validated by the POP-Q system.
  
  
  CONCLUSIONS
  In addition to existing methods, 3D modelling is a useful tool for evaluating pelvic floor mobility. Further investigation of the pelvic floor dynamic features in women is necessary.
authors.affiliation: Department of Female and Functional Urology, Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, 21-2, Vucheticha street, Moscow, 127473, Russian Federation.
authors.forename: George R
authors.initials: GR
authors.lastname: Kasyan
authors.affiliation: Department of Female and Functional Urology, Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, 21-2, Vucheticha street, Moscow, 127473, Russian Federation. tatatu@yandex.ru.
authors.forename: Nataliya V
authors.initials: NV
authors.lastname: Tupikina
authors.affiliation: Department of Female and Functional Urology, Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, 21-2, Vucheticha street, Moscow, 127473, Russian Federation.
authors.forename: Dmitry Yu
authors.initials: DY
authors.lastname: Pushkar
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D061848:Optical Imaging / Q000295:instrumentation / Q000379:methods*; D017773:Pelvic Floor / Q000000981:diagnostic imaging* / Q000503:physiopathology; D056887:Pelvic Organ Prolapse / Q000000981:diagnostic imaging* / Q000503:physiopathology
keywords: Dynamic 3D models; Pelvic floor mobility; Pelvic organ prolapse