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International Urogynecological Consultation: clinical definition of pelvic organ prolapse

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Abstract

Introduction and hypothesis

This segment of Chapter 1 of the International Urogynecology Consultation (IUC) on pelvic organ prolapse (POP) reviews the literature on the clinical definition of POP with the intent of creating standard terminology.

Methods

An international group containing nine urogynecologists and one university-based medical librarian performed a search of the literature using pre-specified search terms in PubMed, Embase, and Scopus. Publications were eliminated if not relevant to the clinical definition of POP, and those articles remaining were evaluated for quality using the Specialist Unit for Review Evidence (SURE). The resulting list of articles was used to inform a comprehensive review and creation of the clinical definition of POP.

Results

The original search yielded 31,931 references, of which 167 were used by the writing group. Ultimately, 78 are referenced in the manuscript.

Conclusions

The clinical definition of POP for this review of the literature is: “anatomical prolapse with descent of at least one of the vaginal walls to or beyond the vaginal hymen with maximal Valsalva effort WITH the presence either of bothersome characteristic symptoms, most commonly the sensation of vaginal bulge, or of functional or medical compromise due to prolapse without symptom bother.”

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Abbreviations

AUGS:

American Urogynecologic Society

ICS:

International Continence Society

IUC:

International Urogynecological Consultation

IUGA:

International Urogynecological Association

POP:

Pelvic organ prolapse

POP-Q:

Pelvic Organ Prolapse Quantification system

SGS:

Society for Gynecologic Surgeons

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Contributions

S.A. Collins: Writing Group Committee Co-Chair, primary writer and editor of the manuscript; M. O’Shea: literature search, writing, editing; N. Dykes: literature search, writing, editing; O. Ramm: literature search, writing, editing; A.E. Edenfield: literature search, writing, editing; K.L. Shek: literature search, writing, editing; K. van Delft: literature search, writing, editing; M. Beestrum: coordinated the large-scale literature search and facilitated group review of the references; K. Kenton: Writing Group Committee Co-chair, writing, editing.

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Correspondence to Sarah A. Collins.

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S.A. Collins, O. Ramm, and K. Kenton are expert witnesses for Ethicon/Johnson & Johnson. S.A. Collins is a paid content expert for MCG, a clearinghouse for medical care guidelines; K.L. Shek receives unrestricted educational grants from Mindray and GE. The remaining authors claim that they have no conflicts of interest.

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Collins, S.A., O’Shea, M., Dykes, N. et al. International Urogynecological Consultation: clinical definition of pelvic organ prolapse. Int Urogynecol J 32, 2011–2019 (2021). https://doi.org/10.1007/s00192-021-04875-y

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