TY - JOUR
T1 - The Effect of Anterior Colporrhaphy
T2 - A Prospective Study Comparing POP-Q and Upright MRI
AU - Eijsink, Julia J.
AU - Simmering, Jaimy A.
AU - Perik, Manon
AU - van der Steen, Annemarie
AU - Grob, Anique T.M.
N1 - Publisher Copyright:
© The International Urogynecological Association 2024.
PY - 2025/2
Y1 - 2025/2
N2 - Introduction and Hypothesis: The high recurrence rate (up to 40%) of native tissue surgery for pelvic organ prolapse (POP) is concerning and a better understanding of the effect of surgery is essential in optimizing treatment. As physical examination (Pelvic Organ Prolapse-Quantification, POP-Q) underestimates the degree of prolapse, upright assessment may provide new insights. Therefore, we compared supine POP-Q with upright magnetic resonance imaging (MRI) examination of the anatomical effect of native tissue POP surgery on the pelvic anatomy.Methods: This prospective study included 59 women with stage ≥ 2 anterior compartment prolapse undergoing solely anterior colporrhaphy (AC) or in combination with posterior colporrhaphy (PC), sacrospinous hysteropexy (SSH) or Manchester Fothergill (MF). Preoperatively and 6 weeks postoperatively, anatomical measurements were obtained: POP-Q and upright MRI. The Patient Global Impression of Improvement (PGI-I) questionnaire was completed 6 weeks postoperatively.Results: Significant lift of the lowest point of the bladder was observed on both POP-Q (37 ± 18 mm) and upright MRI (26 ± 22 mm), which was 10 ± 17 mm (p < 0.001) larger on POP-Q than on upright MRI. Symptomatic improvement (PGI-I) was reported by 93.2% of the patients, which showed a weak correlation with the bladder lift on upright MRI (Spearman’s ρ −0.301, p = 0.021), but no correlation with the bladder lift on POP-Q (Spearman’s ρ −0.078, p = 0.565).Conclusions: The POP-Q examination overestimates the anatomical result of native tissue POP repair on the anterior vaginal wall by 1 cm compared with upright MRI examination upon 6 weeks’ follow-up. Upright MRI examination is suggested to relate better to symptomatic outcome than does POP-Q examination.
AB - Introduction and Hypothesis: The high recurrence rate (up to 40%) of native tissue surgery for pelvic organ prolapse (POP) is concerning and a better understanding of the effect of surgery is essential in optimizing treatment. As physical examination (Pelvic Organ Prolapse-Quantification, POP-Q) underestimates the degree of prolapse, upright assessment may provide new insights. Therefore, we compared supine POP-Q with upright magnetic resonance imaging (MRI) examination of the anatomical effect of native tissue POP surgery on the pelvic anatomy.Methods: This prospective study included 59 women with stage ≥ 2 anterior compartment prolapse undergoing solely anterior colporrhaphy (AC) or in combination with posterior colporrhaphy (PC), sacrospinous hysteropexy (SSH) or Manchester Fothergill (MF). Preoperatively and 6 weeks postoperatively, anatomical measurements were obtained: POP-Q and upright MRI. The Patient Global Impression of Improvement (PGI-I) questionnaire was completed 6 weeks postoperatively.Results: Significant lift of the lowest point of the bladder was observed on both POP-Q (37 ± 18 mm) and upright MRI (26 ± 22 mm), which was 10 ± 17 mm (p < 0.001) larger on POP-Q than on upright MRI. Symptomatic improvement (PGI-I) was reported by 93.2% of the patients, which showed a weak correlation with the bladder lift on upright MRI (Spearman’s ρ −0.301, p = 0.021), but no correlation with the bladder lift on POP-Q (Spearman’s ρ −0.078, p = 0.565).Conclusions: The POP-Q examination overestimates the anatomical result of native tissue POP repair on the anterior vaginal wall by 1 cm compared with upright MRI examination upon 6 weeks’ follow-up. Upright MRI examination is suggested to relate better to symptomatic outcome than does POP-Q examination.
KW - 2025 OA procedure
KW - Pelvic Inclination Correction System
KW - Pelvic organ prolapse
KW - Pelvic Organ Prolapse-Quantification
KW - Upright MRI
KW - Native tissue repair
UR - http://www.scopus.com/inward/record.url?scp=85212674353&partnerID=8YFLogxK
U2 - 10.1007/s00192-024-06006-9
DO - 10.1007/s00192-024-06006-9
M3 - Article
AN - SCOPUS:85212674353
SN - 0937-3462
VL - 36
SP - 403
EP - 412
JO - International Urogynecology Journal
JF - International Urogynecology Journal
ER -