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. 2021 Jan 3;13(1):e12443.
doi: 10.7759/cureus.12443.

Study of the Relationship Between Pelvic Organ Prolapse Quantification (POP-Q) Staging and Decubitus Ulcer in Pelvic Organ Prolapse

Subha R Samantray  1 , Ipsita Mohapatra  2
Affiliations

Study of the Relationship Between Pelvic Organ Prolapse Quantification (POP-Q) Staging and Decubitus Ulcer in Pelvic Organ Prolapse

Subha R Samantray et al. Cureus. .

Abstract

Introduction The protrusion of pelvic organs and their associated vaginal segments into or through the vagina is called pelvic organ prolapse (POP). One of the worrisome complications of POP is decubitus ulcer.It is a feature of old, long-standing prolapse. The standardized pelvic organ prolapse quantification (POP-Q) system of classification was proposed by the International Incontinence Society (ICS) for staging pelvic organ prolapse in 1996. This system is a clear and reproducible quantification method and has more inter-observer and intra-observer reliability. This study was designed to determine the relationship of the POP-Q stage with the presence and size of decubitus ulcer. Methods A total of 92 cases with pelvic organ prolapse were included in the study. We examined our patients by the POP-Q method and measured the dimension of the decubitus ulcer if present. Results Out of the 92 patients included in the study, 32 cases had a decubitus ulcer. As the POP-Q stage increased, the number of patients with a decubitus ulcer also increased. We also observed that larger dimension (>6 cm2) decubitus ulcers are present in stage 3 and stage 4 POP. A statistically significant correlation was observed between the POP-Q stage and the size of the decubitus ulcer, rs=0.607, p<0.001. Conclusion A decubitus ulcer becomes more common as the POP-Q stage increases. The size of the ulcer also increases with the advancing stage of POP-Q.

Keywords: decubitus ulcer; pelvic organ prolapse; pop-q staging.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. POP-Q system of classification*
Nine points are used in the POP system of quantification. Aa and Ap are 3 cm proximal to the hymen when POP is fully reduced. Ba and Bp reflect the lowest point reached by a POP in the complete prolapsed state. C is the most distal edge of the cervix or vaginal cuff (post-hysterectomy). D is the posterior fornix (if the uterus is in situ). Gh is genital hiatus, Pb is perineal body, tvl is total vaginal length (not shown in the figure). *Adapted from Madhu C et al. How to use the pelvic organ prolapse quantification (POP-Q) system? Neurourology and Urodynamics. 2018;37:S39–S43, with permission from "John Wiley and Sons". [12]
Figure 2
Figure 2. Distribution of cases according to POP-Q staging
POP-Q: pelvic organ prolapse quantification
See this image and copyright information in PMC

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