Comparison of transperineal ultrasound findings and pelvic organ prolapse quantification examination in women with pelvic organ prolapse: A prospective cross-sectional study

Abstract

This study aimed to evaluate and compare the findings of transperineal ultrasound (TPUS) with those obtained through the Pelvic Organ Prolapse Quantification (POP-Q) system in women with symptoms of pelvic organ prolapse (POP). This cross-sectional study evaluated 30 women at a gynecological clinic in Kerman, Iran (March–August 2021). Prolapse severity was assessed during maximum Valsalva using both POP-Q and TPUS. Data analysis in SPSS-25 included Cohen’s kappa for agreement and Student’s t-test for mean comparisons. According to the POP-Q system, Stage II prolapse (POP-Q) was most common in the posterior compartment (78.8%), while TPUS most frequently detected anterior compartment prolapse (56.7%). The highest agreement was between POP-Q stage I anterior prolapse and TPUS anterior findings. Overall agreement was moderate (κ = 0.333), with a significant positive correlation between the two methods' severity assessments. The results indicate a moderate agreement between the POP-Q system and TPUS in the assessment of pelvic organ prolapse. TPUS appears to be a valuable complementary diagnostic tool, particularly for identifying conditions such as enterocele, rectal intussusception, and muscular defects. Further research with larger samples is needed. Given its ability to detect associated pelvic floor abnormalities often missed by physical examination alone, the incorporation of TPUS into the routine diagnostic workup for women with POP symptoms is recommended. Such an approach may improve surgical planning and reduce reoperation rates, and health policymakers should consider including TPUS in clinical guidelines as a standard adjunct to POP-Q assessment.