Urogynecology (Philadelphia, Pa.) · 2025
Phenotypes of Pelvic Organ Prolapse.
СтатьяНазвание и аннотация: Перевод в очереди
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Sayler Zoe, Weston Katie, Johnson Colin M, Cunningham Victoria, Bradley Catherine S, Kenne Kimberly A, Wendt Linder, Ten Eyck Patrick, Kowalski Joseph T
Аннотация
IMPORTANCE: The Pelvic Organ Prolapse Quantification (POP-Q) stages do not correlate with symptoms or characterize important prolapse subtypes.
OBJECTIVES: We hypothesize that clinically meaningful prolapse "phenotypes" utilizing POP-Q measurements can be defined. The primary aim was to define the phenotypes and their frequency. Secondary aims were to compare demographics, medical characteristics, and symptoms between phenotypes.
STUDY DESIGN: Patients who previously underwent prolapse surgery were retrospectively categorized into 1 of 8 phenotypes based on 2 principles: (1) prolapse exists when the anterior or posterior vaginal wall descend to the hymen or the apex descends half total vaginal length, and (2) prolapse may exist in anterior, posterior, and/or apical compartments. Demographics, medical characteristics, and Pelvic Floor Distress Inventory-20 (PFDI-20) responses were compared. Linear and logistic regression models were used for comparisons.
RESULTS: The AC (anterior-predominant and apical) phenotype was most common (231 of 501 patients, 46.1%) and served as the reference for comparisons. The no prolapse, P (isolated posterior), C (isolated apical), and PC (posterior-predominant and apical) phenotypes were younger. The A (isolated anterior) phenotype was older. P, PC, and APC (anterior and posterior and apical) phenotypes had greater body mass index. The P phenotype Colorectal-Anal Distress Inventory scores were higher. Similarly, the PC phenotype had higher scores for bowel splinting and rectal prolapse. Conversely, the C phenotype total PFDI-20 scores were lower ( P = 0.01). Only the APC phenotype had no significant differences in any PFDI-20 question compared with the AC phenotype.
CONCLUSION: These phenotypes may allow for improved understanding, communication, and counseling about prolapse and prolapse treatment.
OBJECTIVES: We hypothesize that clinically meaningful prolapse "phenotypes" utilizing POP-Q measurements can be defined. The primary aim was to define the phenotypes and their frequency. Secondary aims were to compare demographics, medical characteristics, and symptoms between phenotypes.
STUDY DESIGN: Patients who previously underwent prolapse surgery were retrospectively categorized into 1 of 8 phenotypes based on 2 principles: (1) prolapse exists when the anterior or posterior vaginal wall descend to the hymen or the apex descends half total vaginal length, and (2) prolapse may exist in anterior, posterior, and/or apical compartments. Demographics, medical characteristics, and Pelvic Floor Distress Inventory-20 (PFDI-20) responses were compared. Linear and logistic regression models were used for comparisons.
RESULTS: The AC (anterior-predominant and apical) phenotype was most common (231 of 501 patients, 46.1%) and served as the reference for comparisons. The no prolapse, P (isolated posterior), C (isolated apical), and PC (posterior-predominant and apical) phenotypes were younger. The A (isolated anterior) phenotype was older. P, PC, and APC (anterior and posterior and apical) phenotypes had greater body mass index. The P phenotype Colorectal-Anal Distress Inventory scores were higher. Similarly, the PC phenotype had higher scores for bowel splinting and rectal prolapse. Conversely, the C phenotype total PFDI-20 scores were lower ( P = 0.01). Only the APC phenotype had no significant differences in any PFDI-20 question compared with the AC phenotype.
CONCLUSION: These phenotypes may allow for improved understanding, communication, and counseling about prolapse and prolapse treatment.