Is Urethral Mobility Really Being Assessed by the Pelvic Organ Prolapse Quantification (POP‐Q) System?
作者:
Stephanie Cogan,
Anne Weber,
Jeffrey Hammel,
期刊:
Obstetrics & Gynecology
(OVID Available online 2002)
卷期:
Volume 99,
issue 3
页码: 473-476
ISSN:0029-7844
年代: 2002
出版商: OVID
数据来源: OVID
摘要:
OBJECTIVETo estimate the relationship between Q-tip measurement of urethral hypermobility and visual assessment of the urethrovesical junction as assessed by points Aa and Ba of the pelvic organ prolapse quantification (POP-Q) system.METHODSA total of 274 patients with pelvic organ pro-lapse or urinary incontinence had preoperative Q-tip test straining angles and POP-Q staging measurements. By the Q-tip test, urethral hypermobility was defined as a straining angle of 30 degrees or greater relative to the horizontal. As defined in the POP-Q system, point Aa is located in the midline of the anterior vaginal wall 3 cm from the external urethral meatus and represents the urethrovesical junction. Point Ba represents the most dependent position of the anterior vaginal wall. The correlation between point Aa of the POP-Q system and the Q-tip test was assessed using the Spearman correlation coefficient. Similar assessments were made for point Ba.RESULTSMean age of the 274 subjects was 58.5 ± 11.8 years; mean parity was 3.1 ± 1.6. A total of 104 patients reported prior surgery for prolapse or incontinence. Mean Q-tip straining angle was 61 ± 20 degrees; 258 (94%) had urethral hypermobility. Values of point Aa ranged from −3 cm to +3 cm, with median 0 cm. The correlation coefficient between the Q-tip straining angle and point Aa wasr= 0.47 (P< .001). Urethral hypermobility was observed in 95% of patients with stage II prolapse at point Aa and in 100% of patients with stages III and IV prolapse at point Aa. The correlation coefficient between the Q-tip straining angle and point Ba wasr= 0.32 (P< .001).CONCLUSIONAlthough the correlation between the Q-tip straining angle and point Aa of the POP-Q was moderately strong, one value cannot be predicted from the other. The Q-tip test may be unnecessary in patients with stages II, III, and IV prolapse at point Aa as virtually all such patients demonstrate urethral hypermobility.
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