Authors: Gil Levy, Anat Beck, Anat From, Haim Krissi
Objective: The study aimed to determine if a single preoperative objective measure of the Pelvic Organ Prolapse Quantification (POP-Q) system, the Ba, (which represents the distal leading point of the anterior vaginal wall), predicts a successful outcome in patients presenting with ≥ stage 3 pelvic organ prolapse (POP) who undergo a transvaginal repair.
Methods: Patients with ≥ stage 3 POP managed with transvaginal mesh implantation were divided into 2 groups based on preoperative Ba measurement (Group 1; Ba = 2-3 cm and Group 2; Ba ≥ 4 cm). An anatomically successful outcome was defined as Ba <1cm.
Results: There were 138 women surgically managed between 2009 and 2013 with complete follow-up available on 113 cases (median age 62.5 years; range 42-83 years). The median follow-up period was 29 months (range 8-38 months). Of 89 women with stage ≥ 3 POP there were 39 cases in Group 1 and 50 patients in Group 2. There was a significantly lower postoperative Ba in Group 1 cases when compared with Group 2 patients (-2.61 cm vs. -1.74 cm; P = 0.03). Logistic regression analysis failed to discern any effect on a successful outcome of factors normally responsible for prolapse (age, parity, BMI, prior surgery or operative delivery).
Conclusion: A favorable anatomic outcome after transvaginal surgery for POP can be anticipated with a preoperative Ba < 4 cm. Future studies are required assessing the value of the preoperative POP-Q measurements in patients with ≥ 3rd degree POP using different types of surgery.
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