RT journal article
T1 Multicompartmental prolapse: A comparative study between clinical examination and ultrasound
A1 García-Mejido, José Antonio
A1 Salas Álvarez, Olaya
A1 Bugatto González, Fernando
A1 Fernández-Palacín, A.
A1 Fernández Palacín, Fernando
A1 Sainz Bueno, José Antonio
A2 Estadística e Investigación Operativa
A2 Materno-Infantil y Radiología
K1 pelvic organ prolapse
K1 POP-Q system
K1 surgery
K1 ultrasonography
AB Objective: The accurate diagnosis of multicompartment pelvic organ prolapse (POP) is fundamental to surgical success. This study aims to compare the diagnostic performance of transperineal ultrasound against clinical examination (pelvic organ prolapse quantification, POP-Q) for the detection of compartmental defects in patients with multicompartment POP, using assessment under spinal anesthesia as the reference standard. Method: A prospective randomized diagnostic accuracy study was designed, including 129 patients scheduled for multicompartment POP surgery. Patients were randomly assigned to undergo either a preoperative POP-Q two-dimensional transperineal ultrasound assessment. The reference standard for all patients was the intraoperative POP-Q assessment, conducted under spinal anesthesia immediately before surgery. Sensitivity, specificity, and likelihood ratios (LR) were calculated for each method and compartment. Results: Both techniques demonstrated high sensitivity for the diagnosis of cystocele (100% vs 98.3%). However, their performance varied across the other compartments. Ultrasound showed superior specificity for uterine prolapse (73.4% vs 45.4%) and rectocele (86.3% vs 66.0%) and was particularly robust in confirming enterocele (LR+ of 10.5). In turn, clinical examination had a higher sensitivity for detecting rectocele (61.5% vs 21.4%) and was highly reliable for ruling out cystocele and uterine prolapse (LR− of 0). Conclusion: Clinical examination and ultrasound are complementary in the diagnosis of prolapse. Their combined use is key to accurate surgical planning.
PB John Wiley and Sons Ltd
SN 1879-3479
YR 2026
FD 2026
LK http://hdl.handle.net/10498/40498
UL http://hdl.handle.net/10498/40498
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 06-nov-2026