scholarly journals Pelvic Organ Prolapse Quantifi cation Accuracy for Elongasio Cervix Diagnose in Pelvic Organ Prolapse Patients

2020 ◽  
pp. 52-60
Author(s):  
Tyas Priyatini ◽  
Finish Fernando ◽  
Lucky S. Widyakusuma ◽  
Shirley T. Anggraeni ◽  
Kukuh W. Kustarto
Keyword(s):  
Body Mass Index ◽  
Pelvic Organ Prolapse ◽  
Gold Standard ◽  
Pelvic Organ ◽  
Cervical Length ◽  
Pelvic Organ Prolapse Quantification ◽  
Cross Sectional ◽  
Cervical Elongation ◽  
Consecutive Sampling ◽  
Sensitivity Specificity

Abstract Objective: To know sensitivity, specificity and accuracy of Pelvic Organ Prolapse Quantification (POP-Q) to measure cervical length for cervical elongation diagnose in Pelvic Organ Prolapse (POP) patients with gold standard was the anatomical cervical length from hysterectomy result. Methods: Diagnosis research, cross-sectional, consecutive sampling. POP-Q was taken before the operation and the anatomical cervical length was from hysterectomy result Results: Sixty six subject, 1.5% 2nd stage POP, 45.5% 3rd stage POP, and 53.0 % 4th stage POP. Mean (± sd) age and body mass index consecutively59.88 years (± 9.347) and 24.41 (± 3.67) kg/m2. Median (min-max) cervical length POP-Q and anatomy consecutively 4 cm (1-12) and 5 cm (3-10). Sensitivity, Specificity dan Accuracy POP-Q consecutively 79%, 58% dan 68% Conclusion: POP-Q has good specificity (79%) but with less sensitivity (58%) with accuracy 68% to diagnose cervical elongation in POP Keywords: accuracy, cervical elongation, cervical length,  pelvic organ prolapse,  pelvic organ prolapse quantification (POP-Q), sensitivity, specificity.   Abstrak Tujuan: Untuk mengetahui nilai sensitivitas, spesifisitas dan akurasi Pelvic Organ Prolapse Quantification (POP-Q) untuk menilai panjang serviks sebagai diagnosis elongasio serviks pada pasien POP dengan baku emas pengukuran anatomi serviks dari hasil histerektomi. Metode: Uji diagnosis, potong lintang, consecutive sampling. Data diambil dari pemeriksaan POP-Q dan pengukuran anatomi serviks dari hasil histerektomi. Hasil : Enam puluh enam subjek, 1,5% POP derajat 2, 45,5% POP derajat 3 dan 53,0 % POP derajat 4. Rerata(± sb)usia dan Indeks Massa Tubuh (IMT) berturut – turut 59,88 tahun (± 9,347) dan 24,41 (± 3,67) kg/m2. Median (min-maks) panjang serviks POP-Q dan anatomi berturut – turut 4 cm (1-12) dan 5 cm (3-10).  Sensitivitas, spesifisitas, dan akurasi POP-Q berturut – turut 79%, 58% dan 68% Kesimpulan : Pemeriksaan POP-Q memiliki spesifitas yang baik (79%) tetapi dengan sensitivitas yang kurang baik (58%) dan akurasi 68% untuk diagnosis elongasio serviks pada prolaps organ panggul. Kata kunci: akurasi, elongasio serviks, panjang serviks,  prolaps organ panggul, pelvic organ prolapse quantification (POP-Q), sensitivitas, spesifisitas

scholarly journals HUBUNGAN ANTARA USIA, PARITAS, PEKERJAAN DAN INDEK MASSA TUBUH DENGAN KEJADIAN PROLAP ORGAN PANGGUL BERDASARKAN SKOR PELVIC ORGAN PROLAPSE QUANTIFICATION

2018 ◽  
Vol 2 (1) ◽  
pp. 37-43
Author(s):  
Ermawati Ermawati ◽  
Hafni Bachtiar
Keyword(s):  
Body Mass Index ◽  
Pelvic Organ Prolapse ◽  
Body Mass ◽  
Significant Relationship ◽  
Pelvic Organ ◽  
The Body ◽  
Case Group ◽  
Pelvic Organ Prolapse Quantification ◽  
Birth Process ◽  
Pelvic Organs

Pelvic organ prolapse is a condition that affects the quality of women life. Pelvic organ prolapse can be caused by injury until the birth process, the aging process, the composition of the tissue in a woman, a chronic cough, or often do heavy work. Early detection of prolapse associated with Prognosis of anatomy and functional pelvic organs recovery. So we need training and learning more about Pelvic Organ Prolapse Quantification (POPQ) are clearly. The study was conducted by the method of case control study in the department of OB polyclinic of Dr. M. Djamil Padang Hospital from September 2013 until the total sample of 98 patients with 49 control groups and 49 in the case group. Analyzes were connected to assess the association of age, parity, occupation and body mass index with the incidence of pelvic organs prolapse based on POPQ. Score data are presented in tabular form. Data were tested by t-test and chi square test. If p <0.05 indicates significant results. There is a significant relationship between age and the incidence of pelvic organ prolapse (p <0.05) and OR 27,871. there is a significant correlation between parity and the incidence of pelvic organ prolapse (p<0.05) and OR 52,970. From the statistical analysis of the work, it cannot be tested statistically. From the body mass index, there is no significant relationship to the occurrence of pelvic organ prolapse (P> 0.05) and OR 1:00.Keywords: age, parity, occupation, body mass index, pelvic organs prolapse

scholarly journals Tenascin-C is Strongly Expressed in the Anterior Vaginal Walls of Women with Pelvic Organ Prolapse

2016 ◽  
Author(s):  
Risma N. Sulham
Keyword(s):  
Body Mass Index ◽  
Pelvic Organ Prolapse ◽  
Body Mass ◽  
Menopausal Status ◽  
Pelvic Organ ◽  
Cross Sectional Study ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Cross Sectional ◽  
Significance Level

Objectives: To compare the expression of tenascin in the anterior vaginal wall in women with pelvic organ prolapse and without pelvic organ prolapse (POP). Method: This study was a cross sectional study. The study was conducted in RS Dr. Wahidin Sudirohusodo and other network hospitals of Obstetrics and Gynecology Department of Hasanuddin University, Makassar, from 1st January 2011 to 1st April 2012. This study assessed the expression of tenascin in 35 women with pelvic organ prolapse grade III and IV and the controls were 35 women without pelvic organ prolapse. Tenascin expression was assessed by immunohistochemical examination using tenascin antibody staining (mouse monoclonal antibody Novacastratenascin C, code NCLTenasC). Sampling was done by consecutive sampling. Data processed by the chi-square. The significance level used was 0.05. Result: The result of this research shows that with exception of history of bearing baby > 4000 gr weight (p=0.572); age, parity, menopausal status, and body mass index were significantly different between the group. This indicates that the variable does not affect the calculation of research data. While parity, menopausal status and body mass index (BMI), from an analysis of risk factors for POP were associated with increased intensity of tenascin is significant in postmenopausal status, and BMI > 25 (overweight) (p

scholarly journals The effect of women’s body mass index on pelvic organ prolapse: a systematic review and meta analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Chernet Baye Zenebe ◽  
Wagaye Fentahun Chanie ◽  
Aster Berhe Aregawi ◽  
Tamiru Minwuye Andargie ◽  
Muhabaw Shumye Mihret
Keyword(s):  
Systematic Review ◽  
Body Mass Index ◽  
Body Weight ◽  
Pelvic Organ Prolapse ◽  
Body Mass ◽  
Meta Analysis ◽  
Grey Literature ◽  
Experimental Studies ◽  
Pelvic Organ ◽  
Cross Sectional

Abstract Background Pelvic organ prolapse remains the public health challenge globally. Existing evidences report the effect of woman’s weight on the pelvic organ prolapse inconsistently and this urges the need of pooled body weight effect on the pelvic organ prolapse. Although there was a previous work on this regard, it included papers reported before June 18/2015. Thus, updated and comprehensive evidence in this aspect is essential to devise strategies for interventions. Objective This review aimed at synthesizing evidence regarding the pooled effect of body weight on the pelvic organ prolapsed. Methods For this review, we searched all available articles through databases including PubMed, Web of Sciences, CINAHL, JBI library, Cochran library, PsycInfo and EMBASE as well as grey literature including Mednar, worldwide science, PschEXTRA and Google scholar. We included cohort, case–control, cross-sectional and experimental studies which had been reported between March 30, 2005 to March 30, 2020. In the effect analysis, we utilized random model. The heterogeneity of the studies was determined by I2 statistic and the publication bias was checked by Egger’s regression test. Searching was limited to studies reported in the English language. Results A total of 14 articles with 53,797 study participants were included in this systematic review (SR) and meta analysis (MA). The pooled result of this Meta analyses depict that body mass index (BMI) doesn’t have statistical significant association with pelvic organ prolapse. Conclusion This review point out that women’s body mass index has no significant effect on the development of pelvic organ prolapse. However, the readers should interpret the result with cautions due to the presence of considerable limitations in this work. Trial registration The protocol of this systematic review (SR) and meta analysis (MA) has been registered in PROSPERO databases with the Registration number of CRD42020186951

scholarly journals PREDICTIVE ACCURACY OF CERVICAL LENGTH IN MID TRIMESTER ON TRANSABDOMINAL ULTRASOUND FOR CESAREAN SECTION

2020 ◽  
Vol 2020 (1) ◽  
Author(s):  
A Khalid ◽  
MN Anjum ◽  
U Daraaz ◽  
K Hussain ◽  
MA Omer
Keyword(s):  
Cesarean Section ◽  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Predictive Accuracy ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Cervical Length ◽  
Transabdominal Ultrasound ◽  
Cross Sectional ◽  
Sensitivity Specificity

The Cesarean section (CS) delivery is a most frequent surgical technique worldwide. The CS increasing rate and its related problems have drawn an attention towards CS related morbidity. As recommended by WHO, C-section could be carried out only when required medically. In mid-pregnancy cervical extended length predicts the probability of CS early in the pregnancy. The objective of the study is to find the predictive accuracy of cervical length (CL) on transabdominal ultrasound for cesarean section in mid trimester taking mode of delivery as gold standard. It was a cross sectional study in which 362 females were enrolled. Females were undergoing transabdominal ultrasonography for assessment of cervical length. A 2x2 contingency table was generated to calculate sensitivity, specificity, positive predictive valve (PPV), negative predictive value (NPV) and diagnostic accuracy of transabdominal ultrasound taking actual mode of delivery as gold standard. The mean age of the females was 27.92 + 5.75 years while mean parity and mean CL were 2.22 + 1.30 and 35.83 + 7.96 mm, respectively. Among 30 females who had cervical length <25 mm, 24 had CS and 6 had spontaneous vaginal delivery (SVD). Among 332 females who had cervical length >25 mm, 96 had CS and 236 had SVD. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of transabdominal ultrasound for cesarean section were 20.0%, 97.5%, 80.0%, 71.1% and 71.8%, respectively. Study concluded that cesarean section takes place among pregnant females when cervical length is ≤25mm on transabdominal ultrasound during mid trimester.

scholarly journals Clinical Risk Factors for Uterine Cervical Elongation among Women with Pelvic Organ Prolapse

2021 ◽  
Vol 18 (17) ◽  
pp. 9255
Author(s):  
Yi-Yin Liu ◽  
Chiu-Lin Wang ◽  
Zi-Xi Loo ◽  
Kun-Ling Lin ◽  
Cheng-Yu Long
Keyword(s):  
Risk Factors ◽  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Cervical Length ◽  
Uterine Weight ◽  
Cervical Elongation ◽  
Vaginal Length ◽  
Independent Risk Factors ◽  
Cervical Amputation ◽  
Total Vaginal Length

Background: Cervical elongation is commonly associated with pelvic organ prolapse (POP). It was an identified risk for recurrent prolapse after hysteropexy, requiring additional surgeries. The aim of the study is to investigate the risk factors for uterine cervical elongation among women with POP. Methods: In this single-center retrospective cohort study, women who underwent vaginal total hysterectomy for POP between 2014 and 2016 were collected. The cervical and total uterine lengths were measured by pathologists, while the ratio of cervical length to total uterine length were calculated. The cervical elongation is defined as corpus/cervix ratio ≤ 1.5. Results: A total of 133 patients were enrolled in this study. Among these patients, 43 women had cervical elongation and 90 women had normal length of uterine cervix. We found that age > 65 years old (67.4% vs. 42.2%, p = 0.007), total vaginal length ≥ 9.5 cm (65.1% vs. 45.6%, p = 0.035), uterine weight < 51 gm (72.1% vs. 52.2%, p = 0.03), and Pelvic Organ Prolapse Distress Inventory 6 (POPDI-6) ≥ 12 (30.2% vs. 14.4%, p = 0.032) were associated with the risk of cervical elongation. There were no significant differences on preoperative urodynamic parameters in the two groups. Conclusion: The patient age > 65 years old, the total vaginal length of POP-Q system ≥ 9.5 cm, uterine weight < 51 g, and POPDI-6 ≥ 12 are independent risk factors of cervical elongation in women with POP. For women scheduled for pelvic reconstructive hysteropexy, concomitant cervical amputation should be considered.

scholarly journals Excision of elongated cervix during reconstructive surgery in patients with pelvic organ prolapse – pro et contra

2019 ◽  
Vol 4 (3) ◽  
pp. 34-40
Author(s):  
I. A. Eizenach ◽  
V. V. Vlasova ◽  
V. G. Mozes
Keyword(s):  
Pelvic Organ Prolapse ◽  
Reconstructive Surgery ◽  
Primary Outcome ◽  
Pelvic Organ ◽  
Cervical Length ◽  
Long Term Outcomes ◽  
Cervical Elongation ◽  
Mesh Surgery

Aim. To determine whether the cervical elongation affects long-term outcomes of reconstructive surgery of pelvic organ prolapse.Materials and Methods. We consecutively enrolled 99 patients with grade 2-3 pelvic organ prolapse (Pelvic Organ Prolapse Quantification System) who underwent vaginal mesh surgery. Volume and length of the cervix were measured using vaginal ultrasonography immediately before the surgery. Cervical elongation was defined as cervix > 6 cm in length (n = 55). Upon 1 year of follow-up, we evaluated the primary outcome (pelvic organ prolapse) and secondary outcomes (cervical length and volume).Results. After 1 year of follow-up, cervical elongation was still detected in 18.1% of patients with cervical elongation before the surgery but not in those without (p = 0.008). Dyspareunia was documented in 14.5% and 2.2% of women with and without cervical elongation, respectively (p = 0.034). In patients with cervical elongation, the length of the cervix before the surgery and after 1 year of follow-up was 7.6 (7; 7.9) cm and 8.4 (7.9; 8.9) cm, respectively (p = 0.001); the respective values of cervical volume were 23.7 (23.4; 24.4) cm3 and 26.9 (25.7; 31.9) cm3 , respectively (p = 0.001); however, these differences were insignificant in patients without cervical elongation.Conclusion. Cervical excision may be recommended for the patients with pelvic organ prolapse and concurrent cervical elongation (length of the cervix > 6 cm). Cervical preservation in such patients may lead to progression of the elongation even after the correction of pelvic organ prolapse. 

scholarly journals Uterine Prolapse in Postmenopausal Women in the Coastal Areas

2020 ◽  
pp. 203-206
Author(s):  
Juminten Saimin ◽  
Indria Hafizah ◽  
Nina Indriyani ◽  
Ashaeryanto ◽  
Satrio Wicaksono
Keyword(s):  
Pelvic Organ Prolapse ◽  
Postmenopausal Women ◽  
Uterine Prolapse ◽  
Pelvic Organ ◽  
Coastal Areas ◽  
Pelvic Organ Prolapse Quantification ◽  
Consecutive Sampling ◽  
The Third ◽  
Main Complaint ◽  
System Data

Objective: To assess the characteristics of postmenopausal women in the coastal areas that experience uterine prolapse.Methods: This was a retrospective descriptive study conducted at Alpha Gynecology Clinic in Kendari. Samplesare cases of uterine prolapse from coastal areas that visited in January to December 2017. Samples were taken by consecutive sampling. The diagnosis of uterine prolapse is based on the Pelvic Organ Prolapse Quantification system. Data is presented with tables and narration.Results: There were 21 respondents who experienced uterine prolapse. Most respondents were aged 61-70 years (42.8%), work as housewives (71.4%), parity more than 4 (85.7%), and duration of menopause >5 years (100.0%). The most common complaint at the fi rst time was a feeling of a lump in the vagina (81.0%), in the third degree of uterine prolapse (57.1%), and accompanied by comorbidities (66.7%). Conclusions: Uterine prolapse in postmenopausal women in the coastal areas was found in housewives, aged 61-70 years, grande-multiparous, and duration of menopause >5 years. The main complaint was felt a lump in the vagina, in the third degree and accompanied by comorbidities. Counselling, information and education regarding symptoms and management of uterine prolapse need to be done.Keywords: coastal areas, postmenopausal women, uterine prolapse.AbstrakTujuan: Mengetahui karakteristik perempuan postmenopause di daerah pesisir yang mengalami prolapsus uteri.Metode: Penelitian ini bersifat deskriptif retrospektif yang dilakukan di Klinik Ginekologi Alfa di Kendari. Sampel adalah kasus prolapse uteri yang berasal dari daerah pesisir yang berkunjung pada bulan Januari sampai Desember 2017. Sampel diambil secara consecutive sampling. Diagnosis prolapsus uteri berdasarkan sistem Pelvic Organ Prolapse Quantification. Data disajikan dalam bentuk tabel dan narasinya.Hasil: Hasil penelitian menunjukkan terdapat 21 responden yang mengalami prolapsus uteri. Responden terbanyak berusia 61-70 tahun (42,8%), pekerjaan sebagai ibu rumah tangga (71,4%), paritas lebih dari 4 (85,7%), dengan lama menopause lebih dari 5 tahun (100,0%). Keluhan yang paling sering dialami pada saat pertama datang adalah terasa ada yang mengganjal di jalan lahir (81,0%), dengan diagnosis prolapsus uteri derajat 3 (57,1%), dan disertai penyakit penyerta (66,7%).Kesimpulan: Prolapsus uteri pada perempuan postmenopause di daerah pesisir ditemukan pada ibu rumah tangga, usia 61-70 tahun, grande multipara, menopause >5 tahun. Keluhan utama terasa ada yang mengganjal di jalan lahir disertai penyakit penyerta, dengan diagnosis prolapse uteri derajat 3. Perlu dilakukan penyuluhan, konseling dan edukasi mengenai gejala dan penatalaksanaan prolapsus uteri.Kata kunci: daerah pesisir, prolaps uteri, perempuan postmenopause.

scholarly journals Comparison of Pelvic Organ Prolapse Quantification and Simplified Pelvic Organ Prolapse Quantification Systems in Clinical Staging of Iranian Women with Pelvic Organ Prolapse

2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Zinat Ghanbari ◽  
Saloumeh Peivandi ◽  
Maryam Deldar Pasikhani ◽  
Foroohar Darabi
Keyword(s):  
Pelvic Organ Prolapse ◽  
High Reliability ◽  
Staging System ◽  
Pelvic Organ ◽  
Cross Sectional Study ◽  
Clinical Staging ◽  
Pelvic Organ Prolapse Quantification ◽  
Iranian Women ◽  
Perfect Agreement ◽  
Cross Sectional

BACKGROUND፡ Pelvic organ prolapse is a common pelvic disorder among women. A standard staging system is needed to carefully evaluate the extent and severity of the disease, and initiate appropriate treatment. The aim of this study was to compare the two methods of standard and simplified pelvic organ prolapse quantification systems in clinical staging of Iranian women with pelvic organ prolapse.METHODS: This observational cross-sectional study was conducted on all women with complaints of seeing or feeling a vaginal lump or bulge and/or a dragging sensation who were presented to a pelvic floor disorders clinic of Imam Khomeini Hospital in Tehran, Iran, from October 2018 to June 2019. All patients were evaluated in terms of pelvic organ prolapse severity and staging using both instruments. Also, length of time needed to complete the questionnaires were calculated. After data collection, the results of pelvic organ prolapse staging and degree of agreement between two examiners were evaluated.RESULTS: A total of 120 women with mean age of 50.92±13.12 years were evaluated. It was shown that there is an almost perfect agreement (kappa coefficient > 0.8) between standard and simplified pelvic organ prolapse quantification systems in all the 3 compartments. Also, there was almost a twofold increase in the time needed to perform standard pelvic organ prolapse quantification (4.16±1.01 minutes) compared to performing simplified pelvic organ prolapse quantification (2.12±1.14 minutes) (p=0.03).CONCLUSION: According to the results of this study, there is a substantial and almost perfect agreement between standard and simplified pelvic organ prolapse quantification systems in clinical staging of Iranian women with pelvic organ prolapse. It seems that using simplified pelvic organ prolapse quantification system is more applicable in clinical practice for staging of pelvic organ prolapse, with high reliability coefficient. 

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