title: Utility of anterior vaginal wall length measurement in vaginal reconstructive surgery.
abstract: OBJECTIVE
  The pelvic organ prolapse quantification system (POP-Q) is the most commonly used method to quantify the extent of pelvic organ prolapse. However, it does not include assessment of anterior vaginal wall length (AVL). The objectives of this study were to characterize AVL and distance to the sacrospinous ligament (SSL), and to examine associations between total vaginal length (TVL), AVL, body mass index (BMI) and age.
  
  
  METHODS
  This was a retrospective chart review of 139 patients with cervix in situ presenting during an 8-month period for initial evaluation to the University of Rochester Medical Center Urogynecology practice. AVL, TVL and distance to the SSL were measured in addition to POP-Q measurements. Age, height, BMI, presenting complaint and prolapse stage were obtained from medical records. Simple linear regression was used to assess the relationship between TVL and AVL. Multivariate regression was used to test independent variables.
  
  
  RESULTS
  The mean ± SD TVL, AVL and distance to the SSL were 9.4 ± 1.2 cm, 7.4 ± 0.9 cm and 7.2 ± 0.9 cm, respectively. All three measurements approached a normal distribution. TVL decreased slightly with age. No association was found between vaginal length and BMI or parity.
  
  
  CONCLUSIONS
  AVL is a useful measurement that may aid in surgical decision-making. Providers should consider using AVL when planning sacrospinous hysteropexy.
authors.affiliation: Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY, 14642, USA.
authors.forename: Amy F
authors.initials: AF
authors.lastname: Collins
authors.affiliation: Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY, 14642, USA.
authors.forename: Paula J
authors.initials: PJ
authors.lastname: Doyle
authors.affiliation: Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY, 14642, USA.
authors.forename: Smitha
authors.initials: S
authors.lastname: Vilasagar
authors.affiliation: University of Rochester Medical Center, 601 Elmwood Ave, Suite 668, Rochester, NY, 14642-8668, USA. Gunhilde_Buchsbaum@urmc.rochester.edu.
authors.forename: Gunhilde M
authors.initials: GM
authors.lastname: Buchsbaum
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001837:Body Weights and Measures / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007512:Ischium / Q000473:pathology; D008022:Ligaments / Q000473:pathology; D016014:Linear Models; D008875:Middle Aged; D015999:Multivariate Analysis; D010298:Parity; D056887:Pelvic Organ Prolapse / Q000473:pathology* / Q000601:surgery; D011247:Pregnancy; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012447:Sacrum / Q000473:pathology; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014621:Vagina / Q000473:pathology* / Q000601:surgery
keywords: Anterior vaginal wall; Hysteropexy; Pelvic organ prolapse quantification; Vaginal length