Adoption of the pelvic organ prolapse quantification system in peer-reviewed literature

Objective The purpose of this study was to examine the method of describing pelvic organ prolapse in the peer-reviewed literature since the introduction of the Pelvic Organ Prolapse Quantification System (POPQ). Study design Representative US and international gynecology and urology journals were selected for review. All prolapse or urinary incontinence articles published in these journals from January to December of 1999 (period 1) and July 2001 to June 2002 (period 2) were hand searched by two independent reviewers. Systems for grading the severity of pelvic organ prolapse were separated into the following categories: POPQ, Baden-Walker system, Beecham system, grade without reference, or nonstandardized system. Chi-square and Fisher exact tests were used for statistical analysis. Results A prolapse staging system was not referenced, or a nonstandardized staging system was used in 54.8% of studies. Overall, the POPQ system was the most common system used (22.6%), followed by the Baden-Walker system (19.8%). There was a statistically significant increase in the use of POPQ from period 1 (13.3%) to period 2 (28%) (P = .03). Articles published in gynecology journals were more likely to use the POPQ system than those published in urology journals (29% vs. 14%, P = .009). Conclusion POPQ was the most common system used; however, the staging system was not cited or a nonstandardized staging system was used in more than half of studies.