Pelvic organ descent and symptoms of pelvic floor disorders

Objective This study evaluates the relationship between symptoms of pelvic floor disorders, and measurement of pelvic organ prolapse. Study design This retrospective cross-sectional study assessed prolapse in 905 women in an academic urogynecologic practice using the Pelvic Organ Prolapse Quantification exam. Symptoms were assessed with a Likert symptom questionnaire and the Urogenital Distress Inventory. Relationships between symptoms and prolapse were analyzed using Spearmanʹs correlation. Results Symptoms of “bulging” correlated moderately to the greatest extent of prolapse (r = 0.4, P< .001). Frequency of bother progressively increases when the leading edge descends from −3 and 0. Between +1 and +5, 90% of women report bother. Symptoms typically attributed to anterior or posterior wall prolapse did not correlate with descent of the respective compartment. Conclusion “Bulging” is the principle symptom that correlates with prolapse severity. We found no discrete anatomic position that discriminates between prolapse as a disease state and normal anatomic variation.