agreement of ultrasound measures with pop-q in patients with pelvic organ prolapse

Background: ultrasound has emerged as a valuable complimentary tool for assessment of pelvic organ prolapse (pop). objectives: the present study aimed to evaluate the correlation between ultrasound measures and clinical staging in patients with suspected pop. patients and methods: forty women with clinical suspicion of pop were enrolled in this cross-sectional study between november 2011 and april 2012. pelvic organ prolapse quantification (pop-q) system was used for clinical staging. perineal ultrasound was performed both at rest and during valsalva maneuver after proper preparation. on mid sagittal view, two reference lines were drawn; midpelvic line (mpl) was defined as the inferior horizontal tangent of symphysis pubis and h line was drawn from the most inferior part of symphysis pubis to the anorectal junction. spearman’s correlation coefficient and kappa coefficient of agreements were used for statistical analysis. results: forty women with the mean age of 49.9  10.07 years were enrolled. excellent correlation was seen between mpl and h line (rho = 0.91, 0.93 and 0.88 in anterior, apical and posterior compartments, respectively). pop-q had good-to-excellent correlation with ultrasound (rho = 0.84, 0.78 and 0.63 forhline and rho = 0.89, 0.82, 0.71 for mpl in anterior, apical and posterior compartments respectively). in anterior and apical compartments, high agreement was seen between clinical and ultrasound staging methods when grouping patients to no prolapse/mild vs. moderate/severe. in the posterior compartment, this agreement was significant when grouping was done based on the presence or absence of pop. conclusion: ultrasound has high correlation with pop-q staging in all compartments for staging of pelvic organ prolapse. ultrasound might be useful in the diagnosis of pop in those with negative clinical examination.