Our official English website, www.x-mol.net, welcomes your
feedback! (Note: you will need to create a separate account there.)
Definition of apical descent in women with and without previous hysterectomy: A retrospective analysis.
PLOS ONE ( IF 2.9 ) Pub Date : 2019-03-15 , DOI: 10.1371/journal.pone.0213617 Gerda Trutnovsky 1, 2 , Kristy P Robledo 3 , Ka Lai Shek 4 , Hans Peter Dietz 2
PLOS ONE ( IF 2.9 ) Pub Date : 2019-03-15 , DOI: 10.1371/journal.pone.0213617 Gerda Trutnovsky 1, 2 , Kristy P Robledo 3 , Ka Lai Shek 4 , Hans Peter Dietz 2
Affiliation
|
BACKGROUND
While normal pelvic organ support has been defined for women with intact uterus, this is not the case for post- hysterectomy vault descent. A recent systematic review found that definitions of apical prolapse are highly variable.
OBJECTIVES
To investigate the relationship between prolapse symptoms and apical POP-Q measurements and establish cutoffs for 'significant apical descent using receiver-operator characteristics (ROC) statistics.
STUDY DESIGN
Retrospective analysis of patients seen at a tertiary urogynecological unit. Evaluation included a standardized interview and clinical assessment using the Pelvic Organ Prolapse Quantification (POP-Q) system. ROC curves were prepared for the relationship between prolapse symptoms and POP-Q measure "C".
RESULTS
The records of 3010 women were available for analysis. Prolapse symptoms were reported by 52.3% (n = 1573), with a mean bother of 5.9 (SD 3.0, range 0-10). POP-Q point "C" was associated with symptoms of prolapse (p <0.0001) and prolapse bother (p <0.0001) on both univariate and multivariate analysis. ROC curves for women with and without uterus were similar, although the relationship between apical descent and symptoms of prolapse was stronger for women with uterus (AUC 0.728 versus 0.678). After controlling for multi-compartment prolapse, the models improved, resulting in AUCs of 0.782 and 0.720. For prediction of prolapse symptoms, cutoffs were set at C = -5 (sensitivity 0.73, specificity 0.67 with uterus in situ, sensitivity 0.59, specificity, 0.73 after hysterectomy).
CONCLUSION
A cut- off for 'significant central compartment descent' of 5 cm above the hymen on Valsalva seems valid regardless of previous hysterectomy.
中文翻译：
接受和不接受子宫切除术的女性的根尖下降的定义：一项回顾性分析。
背景技术虽然已经为子宫完整的女性定义了正常的盆腔器官支持，但子宫切除术后穹ault下降并非如此。最近的一项系统评价发现，根尖脱垂的定义变化很大。目的探讨脱垂症状与心尖POP-Q测量值之间的关系，并使用接收者-操作者特征（ROC）统计数据确定“心尖显着下降”的临界值。研究设计对第三级妇科泌尿科的患者进行回顾性分析。评估包括使用盆腔器官脱垂量化（POP-Q）系统进行的标准化访谈和临床评估。为脱垂症状和POP-Q量度“ C”之间的关系准备了ROC曲线。结果3010名妇女的记录可供分析。报告的脱垂症状为52.3％（n = 1573），平均困扰为5.9（SD 3.0，范围0-10）。在单变量和多变量分析中，POP-Q点“ C”均与脱垂症状（p <0.0001）和脱垂症状（p <0.0001）相关。有和没有子宫的女性的ROC曲线相似，尽管有子宫的女性的根尖下降与脱垂症状之间的关系更强（AUC 0.728 vs 0.678）。在控制了多室脱垂之后，模型得到了改善，其AUC值为0.782和0.720。为了预测脱垂症状，将临界值设置为C = -5（子宫原位敏感性0.73，特异性0.67，子宫切除后敏感性0.59，特异性0.73）。结论：“明显的中隔室下降”的临界值
更新日期：2019-03-17
中文翻译：
接受和不接受子宫切除术的女性的根尖下降的定义：一项回顾性分析。
背景技术虽然已经为子宫完整的女性定义了正常的盆腔器官支持，但子宫切除术后穹ault下降并非如此。最近的一项系统评价发现，根尖脱垂的定义变化很大。目的探讨脱垂症状与心尖POP-Q测量值之间的关系，并使用接收者-操作者特征（ROC）统计数据确定“心尖显着下降”的临界值。研究设计对第三级妇科泌尿科的患者进行回顾性分析。评估包括使用盆腔器官脱垂量化（POP-Q）系统进行的标准化访谈和临床评估。为脱垂症状和POP-Q量度“ C”之间的关系准备了ROC曲线。结果3010名妇女的记录可供分析。报告的脱垂症状为52.3％（n = 1573），平均困扰为5.9（SD 3.0，范围0-10）。在单变量和多变量分析中，POP-Q点“ C”均与脱垂症状（p <0.0001）和脱垂症状（p <0.0001）相关。有和没有子宫的女性的ROC曲线相似，尽管有子宫的女性的根尖下降与脱垂症状之间的关系更强（AUC 0.728 vs 0.678）。在控制了多室脱垂之后，模型得到了改善，其AUC值为0.782和0.720。为了预测脱垂症状，将临界值设置为C = -5（子宫原位敏感性0.73，特异性0.67，子宫切除后敏感性0.59，特异性0.73）。结论：“明显的中隔室下降”的临界值
京公网安备 11010802027423号