Correlation between Plane Assessment of Prolapse Degree and POP-Q Scores after Three-Dimensional Reconstruction of Female Pelvic Organ Prolapse.

Objective: This study aimed to combine dynamic magnetic resonance imaging (MRI) with three-dimensional (3D) reconstruction and form a plane based on osseous structures to evaluate the degree of pelvic organ prolapse (POP). The correlation of this novel evaluation approach with the POP-Q system was assessed.

Method: A retrospective analysis was conducted on 71 POP patients with POP-Q stage ≥ II. The dynamic MRI images of those patients were reconstructed in three dimensions. A plane was created by using the midpoint of the line between the inferior margins of the two pubic bones and the starting points of the superior margins of the bilateral sacrotuberous ligaments (the pubic inferior midpoint - sacrotuberous ligament starting point superior edge plane). Distances from the lowest point of the anterior vaginal wall, cervix, and rectal ampulla to this evaluation plane were measured, modeled, and categorized. The consistency and correlation of the categorized results with POP-Q scores were verified by performing a kappa analysis and Spearman's rank correlation analysis, respectively.

Result: The highest consistency with POP-Q scores was found in the prolapse of the central pelvic cavity (kappa = 0.713, P < 0.05), followed by the anterior POP (kappa = 0.427, P < 0.05), and posterior POP (kappa = 0.261, P < 0.05), with all showing statistically significant differences. The strongest positive correlation was observed between central POP and POP-Q scores (r = 0.864, P < 0.01), followed by posterior POP and POP-Q scores (r = 0.710, P < 0.01), with both exhibiting a strong positive correlation. Anterior POP and POP-Q scores showed a moderate positive correlation (r = 0.586, P < 0.01).

Conclusion: The results of the proposed evaluation method were highly consistent in the anterior and central pelvic cavities and strongly correlated in the central and posterior pelvic cavities. In particular, the assessment of the posterior cavity showed a strong positive correlation with that of the POP-Q system. The evaluation plane demonstrated high consistency and correlation with the POP-Q system.