2019, Number 09
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ABSTRACTObjective: To evaluate the discriminatory value of anatomical cut-off points for symptomatic prolapse in women with pelvic organ prolapse.
Materials and Methods: Retrospective cohort study, conducted at the Gynecological Urology Clinic of the National Institute of Perinatology, between January 2013 and December 2017. Inclusion criteria: patients operated for pelvic organ prolapse, with simplified quantification system of pelvic organ prolapse (S-POP) and interrogation of pelvic floor symptoms according to the International Continence Society (ICS). Sensitivity, specificity, positive predictive value and area under the curve for cut-off points of the anterior (Ba), posterior (Bp) and apical (C) compartments were calculated.
Results: 174 patients were included. The symptom of a foreign body sensation in the vagina increased simultaneously with the degree of prolapse. The areas under the curve (AUC) for point Ba was 0.73 (95% CI 0.65-0.81), Bp 0.63 (95% CI 0.53-0.72) and C 0.78 (95% CI 0.71-0.85). When using the hymen as a cut-off point it was observed that Ba showed a sensitivity of 0.76 and specificity of 0.54, Bp with sensitivity of 0.54 and specificity 0.86 and for C the cut-off point of -5 cm with respect to the hymen had sensitivity of 0.66 and specificity of 0.75.
Conclusion: There is adequate discriminatory value between the hymen as a cut-off point for symptomatic pelvic organ prolapse and foreign body sensation in the vagina, according to the criteria of the simplified quantification system (S-POP).
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