Diagnosis of cystocele type by clinical examination and pelvic floor ultrasound
Article first published online: 28 MAY 2012
Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Ultrasound in Obstetrics & Gynecology
Volume 39, Issue 6, pages 710–714, June 2012
How to Cite
Chantarasorn, V. and Dietz, H. P. (2012), Diagnosis of cystocele type by clinical examination and pelvic floor ultrasound. Ultrasound Obstet Gynecol, 39: 710–714. doi: 10.1002/uog.10156
- Issue published online: 28 MAY 2012
- Article first published online: 28 MAY 2012
- Accepted manuscript online: 28 NOV 2011 10:30AM EST
- Manuscript Accepted: 2 NOV 2011
- pelvic floor ultrasound;
- POP-Q examination;
- retrovesical angle
To use the International Continence Society pelvic organ prolapse quantification (ICS POP-Q) examination to distinguish between two types of cystocele and compare findings with pelvic floor ultrasound results.
We enrolled 94 patients who underwent a structured interview, physical examination using the ICS POP-Q, four-dimensional pelvic-floor ultrasound examination and multichannel urodynamic testing. Cystourethrocele (Green type II) and isolated cystocele (Green type III) were differentiated by the presence of an anterior vaginal wall groove on POP-Q examination and by measurement of the retrovesical angle on pelvic floor ultrasound. Clinical examination was performed by two observers, blinded to each other's results, and an ultrasound examination was subsequently performed by the first observer.
The agreement between two observers for the clinical diagnosis of cystocele types was moderate (κ = 0.561 and 0.544, P < 0.0001). Clinical diagnosis showed moderate to good agreement with ultrasound findings for both observers (κ between 0.318 and 0.794, P ⩽ 0.001).
Radiological cystocele type (Green classification) can be distinguished both clinically and on ultrasound, and agreement between methods as well as interobserver agreement for the clinical diagnosis is moderate to good. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.