Interobserver reliability of pelvic organ prolapse quantification (POP-Q) system

• Published in: Journal of Female Pelvic Floor Medicine Vol. 17; no. 1; pp. 60 - 64
• Main Authors: Ohta, Toshiharu, Kikuchi, Mina, Miwa, Kosei, Ito, Naoki, Yamagiwa, Saburo, Kato, Junko, Moriyama, Yoji, Masue, Takako, Nagatani, Mitsuhiro
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Female Felvic Floor Medicine 16.01.2021; 日本女性骨盤底医学会
• Subjects: diagnosis; interobserver reliability; pelvic organ prolapse; pelvic organ prolapse quantification (POP-Q) system; stage; ステージ; 検者間信頼性; 診断; 骨盤臓器脱
• ISSN: 2187-5669; 2434-8996
• DOI: 10.32310/jfpfm.17.1_60

OBJECTIVE: Our purpose was to have two examiners who engaged urogynecology at different institution evaluate the interobserver reliability of site-specific measurements and the stages of the pelvic organ prolapse quantification (POP-Q) system.STUDY DESIGN: Subjects were women attending the Urogyne Center of Gifu Red Cross Hospital who presented applicable symptoms or needed regular examinations after POP surgery and completed informed consent procedures. The subjects underwent examinations by two experienced examiners. One examiner was a urologist and the other was a gynecologist; each examiner was blind to the results of the other’s examination results. The reproducibility of the nine site-specific measurements was analyzed with Spearman’s correlation coefficient (γs), and the compartment stage and summary stage were analyzed with the weighted kappa correlation coefficient (κ).RESULTS: 32 subjects were recruited (mean age 68.0±9.3 years, mean parity 2.3±1.0, 3 women underwent hysterectomy). Correlations for Aa, Ba, Gh, Ap, Bp, D were statistically high and for C, Pb, Tvl were moderate. (γs for Aa: 0.909, Ba: 0.908, C: 0.486, Gh: 0.803, Pb: 0.440, Tvl: 0.318, Ap: 0.592, Bp: 592, D: 0.600, p=0.077 to <0.001). Staging was very highly reproducible. (κ for anterior wall: 0.873, posterior wall: 0.543, cervix/ vaginal vault: 0.662, summary stage: 0.820, p<0.001). Overall, 72% of the summary stages were fully consistent. With no single subject was there a variance of more than one stage.CONCLUSIONS: Highly consistent interobserver reproducibility of the POP-Q staging was confirmed in this study.