Ismail Alay1, Cihan Kaya2, Ibrahim Karaca3, Sukru Yildiz2, Huseyin Cengiz4, Murat Ekin2, Levent Yasar2. 1. Department of Obstetrics and Gynecology, University of Health Sciences Turkey Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Tevfik Saglam Street, No: 11, Zuhuratbaba, Bakirkoy, Istanbul, Turkey. dr_ismailalay@hotmail.com. 2. Department of Obstetrics and Gynecology, University of Health Sciences Turkey Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Tevfik Saglam Street, No: 11, Zuhuratbaba, Bakirkoy, Istanbul, Turkey. 3. Department of Obstetrics and Gynecology, University of Health Sciences Turkey Tepecik Training and Research Hospital, Izmir, Turkey. 4. Department of Obstetrics and Gynecology, Istanbul Aydın University Faculty of Medicine, Istanbul, Turkey.
Abstract
INTRODUCTION AND HYPOTHESIS: Cervical elongation (CE) has not been clearly defined and has similar symptoms to pelvic organ prolapse. We aimed to evaluate the diagnostic value of preoperative POP-Q examinations, ultrasonographic measurements, and direct cervical length measurement with a Foley catheter in predicting CE on postoperative hysterectomy specimens. METHODS: Fifty-six patients who underwent vaginal hysterectomy for apical pelvic organ prolapse were included. The patients were divided into two groups based on the hysterectomy specimens' corpus/cervix ratio (CCR) as follows: the non-CE group, CCR > 1; the CE group, CCR < 1. The preoperative direct cervical length measurement was performed using 10-French Foley catheters. The recommended cutoff values and sensitivity/specificity analysis of the cervical measurements with Foley, ultrasound, and C-D measurements according to POP-Q were determined by the receiver-operating characteristic analysis. RESULTS: There were 13 patients (23%) in the non-CE group and 43 patients (76%) in the CE group. The mean cervical measurements with Foley catheter and ultrasound, C-D diameter, and postoperative cervix measurements were 49.4 ± 12.6 mm, 42.14 ± 9.4 mm, 41.4 ± 17.2 mm, and 49.5 ± 13 mm, respectively. Cervical measurement with a Foley catheter had 65% sensitivity and 62.5% specificity with a 47.5-mm cutoff value. Among these preoperative measurements, Foley catheter measurements were the most compatible with postoperative cervical measurements. There was no significant association between CE and age, body mass index, menopause duration, point C, and point D. CONCLUSION: Cervical length measurement with a Foley catheter may be preferred for estimation of CE.
INTRODUCTION AND HYPOTHESIS: Cervical elongation (CE) has not been clearly defined and has similar symptoms to pelvic organ prolapse. We aimed to evaluate the diagnostic value of preoperative POP-Q examinations, ultrasonographic measurements, and direct cervical length measurement with a Foley catheter in predicting CE on postoperative hysterectomy specimens. METHODS: Fifty-six patients who underwent vaginal hysterectomy for apical pelvic organ prolapse were included. The patients were divided into two groups based on the hysterectomy specimens' corpus/cervix ratio (CCR) as follows: the non-CE group, CCR > 1; the CE group, CCR < 1. The preoperative direct cervical length measurement was performed using 10-French Foley catheters. The recommended cutoff values and sensitivity/specificity analysis of the cervical measurements with Foley, ultrasound, and C-D measurements according to POP-Q were determined by the receiver-operating characteristic analysis. RESULTS: There were 13 patients (23%) in the non-CE group and 43 patients (76%) in the CE group. The mean cervical measurements with Foley catheter and ultrasound, C-D diameter, and postoperative cervix measurements were 49.4 ± 12.6 mm, 42.14 ± 9.4 mm, 41.4 ± 17.2 mm, and 49.5 ± 13 mm, respectively. Cervical measurement with a Foley catheter had 65% sensitivity and 62.5% specificity with a 47.5-mm cutoff value. Among these preoperative measurements, Foley catheter measurements were the most compatible with postoperative cervical measurements. There was no significant association between CE and age, body mass index, menopause duration, point C, and point D. CONCLUSION: Cervical length measurement with a Foley catheter may be preferred for estimation of CE.
Authors: Christina E Dancz; Lisa Werth; Vanessa Sun; Sandy Lee; Daphne Walker; Begüm Özel Journal: Int Urogynecol J Date: 2013-10-30 Impact factor: 2.894
Authors: Susanne D Thys; Anne- Lotte Coolen; Ingrid R Martens; Herman P Oosterbaan; Jan- Paul W R Roovers; Ben- Willem Mol; Marlies Y Bongers Journal: Int Urogynecol J Date: 2011-04-12 Impact factor: 2.894