Agreement Of Pop-Q Examination With Pelvic Dynamic Mri In Grading Of Pelvic Organ Prolapses

Abstract

Background / Objectives:<br /> Pelvic floor disorders(PFDs) include various symptoms and pathologies, make a considerable decrease in quality of life and involve up to 30-50% of middle aged women and their challenging diagnosis is supported by physical examination and imaging including MRI. In this paper, we are going to assess agreement of POP-Q examination with pelvic dynamic MRI in grading of pelvic organ prolapses.<br /> Patients and Methods:<br /> Totally 61 patients with PFD were enrolled [mean age: 52.7±14.3]. All patients were examined by an expert gynecologist and POP-Q grading were determined regarding anterior [bladder neck and urethra], apex[uterus] and posterior[rectum] pelvic organs. All patients underwent dynamic pelvic MRI by a 3T machine based on standard protocols. we considered pub coccygeal(PC) line as reference. MRI grading were included normal, mild, moderate and severe prolapse and manual exam included normal, stage I, stage II and [stages III or IV] in POP-Q. Agreement of two methods was assessed by kappa coefficient.<br /> Results:<br /> In determining of [moderate and severe] and severe prolapses, Kappa agreement were 0.28 and 0.44 in bladder neck respectively. These figures were 0.03 and 0.14 in urethra,0.6 and 0.6 in uterus and 0.05 and 0.1 in rectum. Corresponding concordance rates were %60 and %80 in bladder neck, %31 and %71 in urethra, %83 and %87 in uterus and %62 and %68 respectively. All these figures were lower considering H-line as reference line.<br /> Conclusion:<br /> Agreement of MRI and POP-Q is good in uterus prolapses while it is worse in anterior and posterior prolapses. MRI could be complementary method for POP-Q examination and combination of these two diagnostic methods seems useful.<br />