Correlation between clinical examination and perineal ultrasound in women treated for pelvic organ prolapse.

INTRODUCTION: Lifetime risk of surgery for female pelvic organ prolapse (FPOP) is estimated at 10 to 20%. Prolapse assessment is mostly done by clinical examination. Perineal ultrasound is easily available and performed to evaluate and stage FPOP. This study's aim is to evaluate the agreement between clinical examination by POP-Q and perineal sonography in women presenting pelvic organ prolapse. MATERIALS AND METHODS: We carried out a prospective study from December 2015 to March 2018 in the gynecologic department of a teaching hospital. Consecutive woman requiring a surgery for pelvic organ prolapse were included. All women underwent clinical examination by POP-Q, perineal ultrasound with measurements of each compartment descent, levator hiatus area and posterior perineal angle. They also answered several functional questionnaires (PFDI 20, PFIQ7, EQ-5D and PISQ12) before and after surgery. Data for clinical and sonographic assessments were compared with Spearman's test and correlation with functional questionnaires was tested. RESULTS: 82 women were included. We found no significant agreement between POP-Q and sonographic measures of bladder prolapse, surface of the perineal hiatus or perineal posterior angle. There was a significant improvement of most of the functional scores after surgery. DISCUSSION: Our study does not suggest correlation between clinical POP-Q and sonographic assessment of bladder prolapse, hiatus surface or perineal posterior angle. Ultrasound datasets were limited by an important number of missing data resulting in a lack of power.

Fertility Check Up: A concept of all-in-one ultrasound for the autonomous evaluation of female fertility potential: Analysis and evaluation of first two years of experience.

RESEARCH QUESTION: Today, women can plan for parenthood and family life, but delaying pregnancy is often associated with anxiety regarding the question of future fertility. We aim to evaluate if there is a benefit to offering fertility evaluation to all women, including those who have no immediate plans for pregnancy. DESIGN: We developed in our reproductive center a new concept of an all-in-one ultrasound open to all women of reproductive age. Fertility Check Up (FCU) is a medical and ultrasound exam followed by an interview with a fertility expert, accessible to all women of childbearing age whether or not they are planning a pregnancy. The FCU provides an anatomical and functional evaluation of the reproductive system and indicates the theoretical likelihood of conception, along with advice from fertility experts. RESULTS: In the first year, 440 women between 24 and 48 were screened, 56% of whom had never attempted to conceive. An anatomical abnormality was found in 58.5% of women, the examination concluded to a low-for-age ovarian reserve in 14% of the cases. 37.5% of the women in our study were referred either for ART treatment, fertility preservation or oocyte donation. Six months after, 50% of the women who had no immediate pregnancy plans stated that the FCU had modified their personal or professional plans regarding a possible future pregnancy. CONCLUSIONS: Fertility assessment for all women, whether infertile or not, with or without immediate pregnancy plans, allows for information, advice, and treatment if necessary.