Perioperative changes in superficial pelvic organ prolapse quantification system measurements after prolapse surgery

Int J Gynaecol Obstet. 2019 May;145(2):239-243. doi: 10.1002/ijgo.12783. Epub 2019 Mar 18.

Abstract

Objectives: To evaluate the values of perineal body (PB) and genital hiatus (GH) before and after posterior repair. We also evaluated the introital surface area (ISA)-a sum of transverse and longitudinal GH measurements.

Methods: This secondary analysis of a prospective case series included 94 women undergoing posterior vaginal prolapse surgery at a consultant urogynecology clinic between October 3, 2011, and October 2, 2014. Patients were examined in clinic using the pelvic organ prolapse quantification system with Valsalva maneuver, and in theatre pre- and postoperatively with traction.

Results: Immediately postoperatively, a statistically significant change (all P<0.001) was noted for GH (mean difference -0.59 cm), PB (-0.56 cm), and ISA (-0.87 cm) compared with preoperative measurement. This effect was maintained for GH (-0.42 cm) and PB (-0.40 cm) at 2 months' follow-up (both P<0.001), and for PB alone (-0.43 cm; P=0.04) at 8 months. ISA had a moderate correlation with GH (r=0.55).

Conclusions: Posterior repair significantly improved PB length at months 2 and 8, and GH length at month 2. ISA did not correlate with prolapse stage. Changes in GH were not maintained beyond postoperative month 2.

Keywords: GH; Introital surface area; PB; POP-Q; Perioperative change; Post-operative; Pre-operative.

MeSH terms

  • Female
  • Humans
  • Middle Aged
  • Pelvic Floor / pathology*
  • Perineum / pathology*
  • Prospective Studies
  • Uterine Prolapse / pathology*
  • Uterine Prolapse / surgery
  • Vagina / pathology*
  • Valsalva Maneuver
  • Vulva / pathology