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Anatomic Criterion for Clinically Relevant Apical Prolapse in Urogynecology Populations
IMPORTANCE: Despite recognition of the critical role of the apex in vaginal support, there is no consensus on the anatomic criteria for clinically relevant apical prolapse. OBJECTIVE: The aim of this study was to define an optimal anatomic criterion for clinically relevant apical prolapse. STUDY DES...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10637301/ https://www.ncbi.nlm.nih.gov/pubmed/37493249 http://dx.doi.org/10.1097/SPV.0000000000001383 |
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author | Oh, Sumin Shin, E. Kyung Lee, So Yeon Kim, Min Ju Lee, Youjoung Jeon, Myung Jae |
author_facet | Oh, Sumin Shin, E. Kyung Lee, So Yeon Kim, Min Ju Lee, Youjoung Jeon, Myung Jae |
author_sort | Oh, Sumin |
collection | PubMed |
description | IMPORTANCE: Despite recognition of the critical role of the apex in vaginal support, there is no consensus on the anatomic criteria for clinically relevant apical prolapse. OBJECTIVE: The aim of this study was to define an optimal anatomic criterion for clinically relevant apical prolapse. STUDY DESIGN: This retrospective cohort study included 3,690 patients who had visited a tertiary hospital for ambulatory urogynecologic care. Vaginal bulge symptom was defined as a response of “somewhat,” “moderately,” or “quite a bit” to Question 3 on the Pelvic Floor Distress Inventory-20. Receiver operating characteristic curves were generated for a vaginal bulge symptom and apical support (Pelvic Organ Prolapse Quantification point C and C/total vaginal length [TVL]). RESULTS: Both point C and the C-to-TVL ratio (C/TVL) had excellent performance for predicting vaginal bulge symptoms (area under the curve, 0.917 and 0.927, respectively). The optimal cutoffs were −3.0 for C and −0.50 for C/TVL. When we analyzed the data set according to the TVL, there was a significant difference in the cutoffs for C, whereas those for C/TVL had little difference. There was no difference in the cutoffs of C and C/TVL according to hysterectomy status. CONCLUSIONS: The C/TVL is more appropriate than point C as a measure to define an anatomic criterion for clinically relevant apical prolapse. Descent of the vaginal apex beyond the halfway point of the vagina could be considered as an anatomic threshold for clinically relevant apical prolapse. This finding needs to be validated in nonurogynecology populations. |
format | Online Article Text |
id | pubmed-10637301 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-106373012023-11-15 Anatomic Criterion for Clinically Relevant Apical Prolapse in Urogynecology Populations Oh, Sumin Shin, E. Kyung Lee, So Yeon Kim, Min Ju Lee, Youjoung Jeon, Myung Jae Urogynecology (Phila) Original Research IMPORTANCE: Despite recognition of the critical role of the apex in vaginal support, there is no consensus on the anatomic criteria for clinically relevant apical prolapse. OBJECTIVE: The aim of this study was to define an optimal anatomic criterion for clinically relevant apical prolapse. STUDY DESIGN: This retrospective cohort study included 3,690 patients who had visited a tertiary hospital for ambulatory urogynecologic care. Vaginal bulge symptom was defined as a response of “somewhat,” “moderately,” or “quite a bit” to Question 3 on the Pelvic Floor Distress Inventory-20. Receiver operating characteristic curves were generated for a vaginal bulge symptom and apical support (Pelvic Organ Prolapse Quantification point C and C/total vaginal length [TVL]). RESULTS: Both point C and the C-to-TVL ratio (C/TVL) had excellent performance for predicting vaginal bulge symptoms (area under the curve, 0.917 and 0.927, respectively). The optimal cutoffs were −3.0 for C and −0.50 for C/TVL. When we analyzed the data set according to the TVL, there was a significant difference in the cutoffs for C, whereas those for C/TVL had little difference. There was no difference in the cutoffs of C and C/TVL according to hysterectomy status. CONCLUSIONS: The C/TVL is more appropriate than point C as a measure to define an anatomic criterion for clinically relevant apical prolapse. Descent of the vaginal apex beyond the halfway point of the vagina could be considered as an anatomic threshold for clinically relevant apical prolapse. This finding needs to be validated in nonurogynecology populations. Lippincott Williams & Wilkins 2023-11 2023-07-26 /pmc/articles/PMC10637301/ /pubmed/37493249 http://dx.doi.org/10.1097/SPV.0000000000001383 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Original Research Oh, Sumin Shin, E. Kyung Lee, So Yeon Kim, Min Ju Lee, Youjoung Jeon, Myung Jae Anatomic Criterion for Clinically Relevant Apical Prolapse in Urogynecology Populations |
title | Anatomic Criterion for Clinically Relevant Apical Prolapse in Urogynecology Populations |
title_full | Anatomic Criterion for Clinically Relevant Apical Prolapse in Urogynecology Populations |
title_fullStr | Anatomic Criterion for Clinically Relevant Apical Prolapse in Urogynecology Populations |
title_full_unstemmed | Anatomic Criterion for Clinically Relevant Apical Prolapse in Urogynecology Populations |
title_short | Anatomic Criterion for Clinically Relevant Apical Prolapse in Urogynecology Populations |
title_sort | anatomic criterion for clinically relevant apical prolapse in urogynecology populations |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10637301/ https://www.ncbi.nlm.nih.gov/pubmed/37493249 http://dx.doi.org/10.1097/SPV.0000000000001383 |
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