Correlation between Clinical Diagnosis of Pelvic Organ Prolapse via Pelvic Floor Ultrasound and Quantitative Staging Method: A Clinical Study.

Abstract

Objectives: To validate the diagnostic accuracy of pelvic floor ultrasound (PFUS) for pelvic organ prolapse (POP) and its correlation with the Pelvic Organ Prolapse Quantification (POP-Q) staging system by performing a rigorous quantitative comparison of anatomical measurements between women with POP and asymptomatic controls.

Methods: In this prospective observational study, 80 women with clinically confirmed POP and 60 asymptomatic controls underwent standardized PFUS and POP-Q examinations. PFUS was utilized to measure bladder, uterine, and rectal positions during maximal Valsalva maneuver. POP-Q staging was conducted by two blinded urogynecologists (inter-rater reliability κ = 0.87). Statistical analyses included Spearman's correlation (ρ), diagnostic performance metrics (sensitivity, specificity, accuracy), and group comparisons using t-tests or chi-square tests.

Results: The POP group exhibited significant organ descent versus controls, including mean bladder descent (4.5 ± 1.2 cm vs. 1.8 ± 0.3 cm; P = 0.004) and uterine descent (5.2 ± 1.4 cm vs. 2.05 ± 0.40 cm; P = 0.012). PFUS measurements demonstrated strong correlation with POP-Q stages (compartment-specific ρ = 0.87-0.91). Overall agreement was 90.0% (ρ = 0.92, P < 0.001), with high diagnostic accuracy (93.5%), sensitivity (>90%), and specificity (>96%).

Conclusions: PFUS is a reliable, non-invasive method to quantify pelvic organ displacement, showing excellent agreement with the clinical standard POP-Q system. Its high diagnostic performance supports its integration into clinical practice for objective diagnosis, severity grading, and comprehensive anatomical characterization of POP.

Advances in knowledge: This study provides robust evidence validating PFUS as a reproducible objective tool for POP assessment.