Distribution of pelvic organ support measures in a population-based sample of middle-aged, community-dwelling African American and white women in southeastern Michigan

• Published in: American journal of obstetrics and gynecology Vol. 198; no. 5; pp. 548.e1 - 548.e6
• Main Authors: Trowbridge, Elisa R., MD, Fultz, Nancy H., PhD, Patel, Divya A., PhD, DeLancey, John O.L., MD, Fenner, Dee E., MD
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Philadelphia, PA Mosby, Inc 01-05-2008; Elsevier
• Subjects: Adult; African Americans; Biological and medical sciences; Cross-Sectional Studies; epidemiology; European Continental Ancestry Group; Female; Gynecology. Andrology. Obstetrics; Humans; Hymen - anatomy & histology; Medical sciences; Michigan; Middle Aged; Obstetrics and Gynecology; Parity; pelvic organ prolapse quantification system (POP-Q); pelvic organ support; Pelvis - anatomy & histology; Pregnancy; Urinary Incontinence - pathology; Uterine Prolapse - classification; Uterine Prolapse - diagnosis; Uterine Prolapse - pathology; Vagina - anatomy & histology; United States; North America; America; Michigan; epidemiology; pelvic organ support; pelvic organ prolapse quantification system (POP-Q); Human; Middle age; Sample; White; Pelvic cavity; Distribution; Race; Adult; Female; Caucasoid; Woman; Community; Public health; African American; Organ
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2008.01.054

Objective The purpose of this study was to report the distribution of pelvic support among a population-based sample of middle-aged community-dwelling women, as defined by pelvic organ prolapse quantification (POP-Q) and study factors that might influence POP-Q measurements. Study Design We conducted a secondary analysis of a population-based study of community-dwelling, African American and white women aged 35-64 years from southeastern Michigan. Three hundred ninety-four women consented to physical examination using the POP-Q. Statistical analysis included descriptive statistics and multivariable regression. Estimates were weighted to reflect probability and nonresponse characteristics of the sample to increase generalizability of the findings. Results The following values were the mean values for POP-Q points: Aa and Ba = −1.2 cm, C = −6.5 cm (intact uterus), C = −6.9 cm (hysterectomy), and Ap and Bp = −1.8 cm. The POP-Q stages were organized in the following manner: stage 0, 8.8%; stage I, 21.4%; stage II, 67.7%; stage III, 2.1%. Increasing vaginal parity was associated with increasing descent of the anterior, apical, and posterior vaginal wall ( P < .001). Conclusion In this population-based study of women from southeastern Michigan, 90% of the women had anterior and posterior vaginal wall support that was above or extended to the hymen. Increasing vaginal parity was associated with increasing descent of the anterior, posterior, and vaginal apex.