Whether the Pelvic Organ Prolapse can be appropriately Screened without a Physical Examination? (A Community Based Study)

Pelvic prolapse is one of the most common disorders with a great impact on women’s quality of life. This study was performed with the aim of developing and evaluating a simple screening method for identification of pelvic organ prolapse among general population of women. In this cross-sectional study, first a pilot study was carried out on 200 women who referred to Reproductive Endocrinology clinic for annual gynecologic examination. The standard Pelvic Floor Disorder Inventory questionnaire was filled up for subjects and their pelvic floor prolapse was assessed using standard pelvic examination. Then, the pelvic organ prolapse screening instrument (POPSI) was developed that contained 4 selected questions. At the second phase of the study, the sensitivity and specificity of the selected questions was evaluated in 954 women who were selected by proportionate cluster sampling. Data was analyzed by SPSS 15 using independent t-test, Chi-square test and logistic regression. Pelvic Floor Disorder Inventory had 45/5% sensitivity and 87/4% specificity in general population for identification of pelvic prolapse. The selected question of “urinary incontinence after laughing, sneezing or coughing” had 40.7% sensitivity and 80% specificity in assessing the pelvic floor prolapse. Although screening based on symptoms is an appropriate choice for investigating women with pelvic prolapse and can facilitate community based studies, it seems that it lacks sufficient sensitivity in general population and have better efficacy in women who are more aware of such disorders and symptoms.