A comparison of preoperative and intraoperative evaluations for patients who undergo site-specific operation for the correction of pelvic organ prolapse

Objective: We compared preoperative and intraoperative assessments of pelvic organ prolapse to ascertain whether differences existed. Study Design: This study is a retrospective analysis of information that was collected of 193 women who underwent reconstructive operation for pelvic organ prolapse between January 1994 and April 1999 by the senior author (B. L. S.) in this institution. Support for the urethra, bladder, cervix or vaginal cuff, cul-de-sac, and rectum were assessed with the Baden-Walker halfway system before and during the operations. Results: Preoperative and intraoperative assessments were significantly correlated (Spearman rank order correlation, 0.85-0.94). A comparison of the assessments revealed significantly greater prolapse at the urethra, cervix/cuff, cul-de-sac, and rectum on intraoperative evaluation (P ≤ .00007). Conclusion: Intraoperative evaluation of women who are to undergo reconstructive operation for pelvic organ prolapse may reveal greater prolapse at selected sites than previously noted in up to 32% of patients. (Am J Obstet Gynecol 2002;186:1155-9.)