Background: The evaluation of a genital prolapse has to include the POPQ-pelvic organ position quantification as a descriptive system.
Objectives: Effectiveness of our modification of the POPQ in the diagnosis of supravaginal cervical elongation.
Methods: We evaluated our modification: Bal (midpoint of distance Aa/Va); Vas (most proximal point of anterior vaginal wall); Va (attachment of anterior vaginal wall to cervix); Vp (attachment of posterior vaginal wall to cervix); Vps (most proximal point of posterior vaginal wall); SU (attachment of sacrouterine ligaments to cervix); Bp1 (midpoint of distance Ap/Vp); as well as some level distances: (Vas-Va), (Vp-SU), (Vps-Vp), (Aa-Ba1) in 358 patients, divided into: group A-stage I/II prolapse; group B-stage I/II prolapse and cervical elongation; group C-stage III/IV prolapse; group D-stage III/IV prolapse and cervical elongation; group E-stage 0 prolapse and stress incontinence during Valsalva maneuver (Vm) and Pozzy maneuver (Pm).
Results: In cases with a genital prolapse without cervical elongation, with presence of uterosacral ligaments/ upper paracolpium deterioration, the points, such as: Ba1, Vas, Va, Vp, Vps, SU, D, Bp1 came down during Pm. In cases with cervical elongation, without upper paracolpium deterioration and strong uterosacral ligaments, points: SU, D, Bp1 were higher, and level distances: (Vas-Va), (Vp-SU), (Vps-Vp), (Aa-Ba1), (Ap-Bp) greater. In cases with stage 0 prolapse and USI, with only urethrovesical junction deterioration, we found a higher position of Vas, Va, Vp and SU, reflecting the absence of upper paracolpium deterioration.
Conclusion: Our modification seems to be effective in the diagnosis of cervical elongation (Tab. 4, Fig. 3, Ref. 6).
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