Validation of a simplified technique for using the POPQ pelvic organ prolapse classification system
Abstract
Our objective was to determine the inter-examiner agreement of a simplified pelvic organ prolapse quantification (POPQ) exam and to assess its correlation with the standard POPQ exam. This study consists of two parts; both were performed in a prospective, randomized, blinded fashion on women presenting with complaints attributed to pelvic organ support defects. The first study was done to determine the inter-examiner reliability of a simplified POPQ exam. The simplified POPQ exam is based on the POPQ with similar ordinal staging but with only four points measured instead of nine. Forty-eight women underwent exams by five different investigators. The order of exams was randomized and the examiners were blinded to the results of each other's findings. The results of these two exams were compared using weighted kappa statistics. The second part of the study was done to determine the inter-system agreement between the simplified vs standard POPQ exam. A group of 49 women were examined by four different investigators: one using the simplified and the other using standard POPQ exams. The order of the exams was randomized and the examiners were blinded to the results of each other's exam. Kendall's tau-b statistics were used to determine the inter-system agreement. For the inter-examiner reliability of the POPQ exam, the average age was 60+/-13 years. The weighted kappa statistics for the inter-examiner reliability of the simplified prolapse classification system were 0.86 for the overall stage, 0.89 and 0.86 for the anterior and posterior vaginal walls, respectively, 0.82 for the apex/cuff, and 0.72 for the cervix. All demonstrate significant agreement. For the inter-system association between the simplified POPQ and standard POPQ, the average age was 61+/-15 year. The Kendall's tau-b value for overall stage was 0.90, 0.83, and 0.87 for the anterior and posterior walls respectively, and 0.78 for the cuff/apex and 0.98 for the cervix. There is good inter-examiner agreement of a simplified POPQ classification system and it appears to have good inter-system association with the POPQ.
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The study protocol was registered and approved by the Conjoint Health Research Ethics Board at the University of Calgary.
“The study protocol 35 was registered (https:// clinicaltrials.gov/study/NCT04890951)and approved by the Conjoint Health Research Ethics Board at the University of Calgary (REB19-2134).36”
From Hysterectomy versus uterine preservation for pelvic organ prolapse surgery: a prospective cohort study (2025) · cites this paper as [35]
POP-Q exams could have been influenced by knowledge of surgical group.
“Despite good interrater reliability of the POP-Q system, 35 exams could have been influenced by knowledge of surgical group.”
From Hysterectomy versus uterine preservation for pelvic organ prolapse surgery: a prospective cohort study (2025) · cites this paper as [35]
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- Authors
- Swift, S., Morris, S., McKinnie, V., Freeman, R., Petri, E., Scotti, R. J., & Dwyer, P.
- Affiliations
- Medical University of South Carolina (US)
- Derriford Hospital (GB)
- University of California, Los Angeles (US)
- Corresponding author
- Swift, Steven
- Venue
- International Urogynecology Journal
- Published
- 2006-04-06
- Volume
- 17
- Issue
- 6
- Pages
- 615-620
- ISSN
- 0937-3462 (ISSN-L)
- 1433-3023
- OpenAlex
- W2037514656
- Cited by
- 133
- References
- 15
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 6 · 2023: 6 · 2022: 3 · 2021: 6 · 2020: 6 · 2019: 6 · 2018: 13 · 2017: 12 · 2016: 8 · 2015: 7 · 2014: 9 · 2013: 3 · 2012: 5
- FWCI
- 2.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- International Urogynecology Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Reliability and Agreement in Measurement
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Keywords
- pelvic organ prolapse, inter-examiner agreement, anterior vaginal wall, posterior vaginal wall, uterine cervix
- MeSH terms
- Aged, Female, Humans, Middle Aged, Prospective Studies, Uterine Prolapse, Reproducibility of Results
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