Relationship between pelvic floor symptoms and POP-Q measurements

Aim: To investigate the relationship between pelvic floor symptoms using the Pelvic Floor Bother Questionnaire (PFBQ) and the Pelvic Organ Prolapse Quantification system (POP-Q) measurements. Methods: This was a retrospective study. Consecutive women seeking care for pelvic floor symptoms were evaluated. The PFBQ was self-administered by all patients before they were examined by three urogynecologists according to the POP-Q. Pearson's correlation and a receiver operating characteristic (ROC) curve were used to investigate relationship between symptoms and POP-Q findings. Results: Four hundred and sixty-seven patients completed the questionnaire and underwent standardized pelvic examination. Anterior, posterior and apical compartment prolapse were found in 95.5%, 78.8% and 35.9%, respectively. Moderate correlations were found between a feeling of bulging and the increasing severity of prolapse of all compartments. For all 8 pelvic floor symptoms, the area under the curve for a feeling of bulge with point Ba and point C was significantly greater than 0.7, suggesting fair ability to predict symptomatic patients. The sensitivity and specificity of the symptom were 60% and 83% when point Ba was 1 cm below the hymen. Whereas they were 55% and 83% when point C was 3 cm above the hymen. Conclusions: The feeling of a bulge in the vagina is the only symptom that correlated with prolapse of all compartments. The specific thresholds for the feeling of a bulge appear to be 1 cm below the hymen for anterior vaginal wall prolapse, and 3 cm above the hymen for apical prolapse. Neurourol. Urodynam. 35:724–727, 2016.