The relationship between clinical symptoms with pop-Q stage

Pelvic organ prolapse (POP) is the descent of pelvic organs beyond the vaginal walls which is associated with bothersome urinary, defecatory, sexual and vaginal mass protrusion symptoms. The present study was performed aimed to investigate the correlation of the symptoms and POP-Q stage.

This cross-sectional study was performed on 335 women with pop symptoms referred to the pelvic floor clinic of Tehran Imam Khomeini hospital in 2018-2019. A checklist of detailed medical history which contains urinary, defecatory, sexual and bulging symptoms due to pelvic organ prolapse was completed by a gynecologist (fellowship of pelvic floor disorders) and the stage of POP was evaluated according to pelvic organ prolapse quantification (POPQ) system. The relationship between clinical symptoms and the stage of POP was assessed. Data were analyzed by SPSS software (version 23) and Chi-square, Fisher's exact test and multivariate regression. P<0.05 was considered statistically significant.

Among women with pelvic organ prolapse symptoms, there was significant correlation between stress and urgency urinary incontinence and lower stage of anterior compartment prolapse (p=0.002, p=0.043, respectively). Also, significant correlation was observed between urgency urinary incontinence and lower stage of posterior compartment prolapse (P=0.04), but there was no correlation between defecatory symptoms and stage of anterior, posterior or apical compartment prolapse (P>0.05). There was significant correlation between vaginal noise and sexual dissatisfaction with lower stage of anterior compartment prolapse (p=0.014, p=0.025, respectively).

Urinary symptoms especially stress and urgency urinary incontinence and sexual dissatisfaction were correlated with lower stage of POP. Also, due to the lack of relationship between defecation symptoms and prolapse stage, complaints of pelvic organ prolapse symptoms may not be related to the severity and stage of prolapse in clinical examination.