Pelvic organ descent and symptoms of pelvic floor disorders

Objective: This study evaluates the relationship between symptoms of pelvic floor disorders, and measurement of pelvic organ prolapse. Study design: This retrospective cross-sectional study assessed prolapse in 905 women in an academic urogynecologic practice using the Pelvic Organ Prolapse Quantification exam. Symptoms were assessed with a Likert symptom questionnaire and the Urogenital Distress Inventory. Relationships between symptoms and prolapse were analyzed using Spearman's correlation. Results: Symptoms of "bulging" correlated moderately to the greatest extent of prolapse (r = 0.4, P < .001). Frequency of bother progressively increases when the leading edge descends from -3 and 0. Between +1 and +5, 90% of women report bother. Symptoms typically attributed to anterior or posterior wall prolapse did not correlate with descent of the respective compartment. Conclusion: "Bulging" is the principle symptom that correlates with prolapse severity. We found no discrete anatomic position that discriminates between prolapse as a disease state and normal anatomic variation.