Publication: Relationship of degree of uterine prolapse between pelvic examination in lithotomy position with cervical traction and pelvic examination in standing position
Issued Date
2018-08-01
Resource Type
ISSN
14333023
09373462
09373462
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2-s2.0-85044952936
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Mahidol University
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SCOPUS
Bibliographic Citation
International Urogynecology Journal. Vol.29, No.8 (2018), 1173-1177
Suggested Citation
Pichai Leerasiri, Parit Wachasiddhisilpa, Pattaya Hengrasmee, Chutimon Asumpinwong Relationship of degree of uterine prolapse between pelvic examination in lithotomy position with cervical traction and pelvic examination in standing position. International Urogynecology Journal. Vol.29, No.8 (2018), 1173-1177. doi:10.1007/s00192-018-3579-5 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/46452
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Title
Relationship of degree of uterine prolapse between pelvic examination in lithotomy position with cervical traction and pelvic examination in standing position
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Abstract
© 2018, The International Urogynecological Association. Introduction and hypothesis: The Pelvic Organ Prolapse Quantification (POP-Q) assessment is a standardized tool for evaluating pelvic organ prolapse (POP). However, intraoperative evaluation reveals greater apical prolapse than do POP-Q scores. There is a need to implement a method for performing POP-Q at the outpatient clinic that reveals maximal prolapse and causes the least pain. This study was performed to compare the degree of uterine prolapse between POP-Q with cervical traction and POP-Q in the standing position. Secondary objectives were to compare pain and acceptability scores between the two examinations. Methods: Women with uterine prolapse stage I or II by routine examination were invited to participate. Comparison of degree of uterine prolapse, POP-Q stages, acceptability score, and pain score between the two types of examinations were undertaken. Results: Seventy-eight participants were recruited. The median point C in routine POP-Q examination was −5 (−9 to +1), −0.5 (−3 to +4) with cervical traction, and −4 (−7 to +2) in the standing position. When examined with cervical traction, 61.5% women were upstaged by one and 9.0% by two compared with examination in the standing position; 39.7% reported visual analog scale (VAS) pain scores of ≥5 under examination with traction, but only 2.6% reported that level of pain in the standing position. There was no significant difference in acceptability scores between groups. Conclusion: In an outpatient clinic setting, POP-Q examination with cervical traction revealed maximal prolapse at an acceptable level of pain. Accordingly, this method is recommended for POP-Q examination.