The effect of bladder fullness on evaluation of pelvic organ prolapse

• Published in: International journal of gynecology and obstetrics Vol. 118; no. 1; pp. 24 - 26
• Main Authors: Haya, Nir, Segev, Eran, Younes, Grace, Goldschmidt, Eyal, Auslender, Ron, Abramov, Yoram
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.07.2012; Elsevier
• Subjects: Aged; Biological and medical sciences; Bladder emptying; Bladder volume; Female; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Middle Aged; Obstetrics and Gynecology; Outcome Assessment (Health Care); Pelvic organ prolapse; Pelvic Organ Prolapse - pathology; POP-Q; Prospective Studies; Severity of Illness Index; Urinary Bladder; Urinary Catheterization; POP-Q; Pelvic organ prolapse; Bladder volume; Bladder emptying; Prolapsus; Pelvic cavity; Urinary bladder; Volume; Gynecology; Urogenital system diseases; Obstetrics; Prolapse
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1016/j.ijgo.2012.02.009

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. Conclusion 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.