Skip to main content
Journal cover image

Accuracy of clinical assessment of paravaginal defects in women with anterior vaginal wall prolapse.

Publication ,  Journal Article
Barber, MD; Cundiff, GW; Weidner, AC; Coates, KW; Bump, RC; Addison, WA
Published in: Am J Obstet Gynecol
July 1999

OBJECTIVE: The objective of this study was to determine the accuracy of clinical assessment of paravaginal defects in women with anterior vaginal wall prolapse. STUDY DESIGN: A retrospective chart review of all women undergoing surgery for anterior vaginal wall prolapse during the years of 1994 to 1996 identified operative notes that described the surgical assessment of paravaginal support. These surgical findings were compared with the preoperative clinical assessment. Clinical parameters that predicted poor correlation were identified. Statistical analysis used the chi(2) test. RESULTS: One hundred seventeen patients had surgery for anterior vaginal prolapse. Seventy had documentation of an intraoperative paravaginal support evaluation. Of these, 44 patients had vaginal procedures, and 26 had abdominal procedures. All patients had at least stage 2 prolapse before surgery, and all were noted to have excellent pelvic support 4 to 6 weeks after surgery. The prevalence of paravaginal defects at surgery was 47% on the right and 41% on the left. The sensitivity and negative predictive value for the clinical assessment for paravaginal defects were good on both the right and left sides, whereas the specificity and positive predictive values were poor. Stage of prolapse, previous hysterectomy, or previous anterior colporrhaphy did not significantly affect the accuracy of the clinical examination in predicting fascial defects. However, previous retropubic urethropexy did significantly decrease the accuracy of the clinical examination in predicting right paravaginal defects (P <.01) but not left. CONCLUSION: Although preoperative clinical assessment for paravaginal defects is useful, it does not substitute for careful intraoperative evaluation for endopelvic fascial defects.

Duke Scholars

Published In

Am J Obstet Gynecol

DOI

ISSN

0002-9378

Publication Date

July 1999

Volume

181

Issue

1

Start / End Page

87 / 90

Location

United States

Related Subject Headings

  • Vaginal Diseases
  • Vagina
  • Sensitivity and Specificity
  • Retrospective Studies
  • Prolapse
  • Predictive Value of Tests
  • Palpation
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Medical Records
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Barber, M. D., Cundiff, G. W., Weidner, A. C., Coates, K. W., Bump, R. C., & Addison, W. A. (1999). Accuracy of clinical assessment of paravaginal defects in women with anterior vaginal wall prolapse. Am J Obstet Gynecol, 181(1), 87–90. https://doi.org/10.1016/s0002-9378(99)70440-0
Barber, M. D., G. W. Cundiff, A. C. Weidner, K. W. Coates, R. C. Bump, and W. A. Addison. “Accuracy of clinical assessment of paravaginal defects in women with anterior vaginal wall prolapse.Am J Obstet Gynecol 181, no. 1 (July 1999): 87–90. https://doi.org/10.1016/s0002-9378(99)70440-0.
Barber MD, Cundiff GW, Weidner AC, Coates KW, Bump RC, Addison WA. Accuracy of clinical assessment of paravaginal defects in women with anterior vaginal wall prolapse. Am J Obstet Gynecol. 1999 Jul;181(1):87–90.
Barber, M. D., et al. “Accuracy of clinical assessment of paravaginal defects in women with anterior vaginal wall prolapse.Am J Obstet Gynecol, vol. 181, no. 1, July 1999, pp. 87–90. Pubmed, doi:10.1016/s0002-9378(99)70440-0.
Barber MD, Cundiff GW, Weidner AC, Coates KW, Bump RC, Addison WA. Accuracy of clinical assessment of paravaginal defects in women with anterior vaginal wall prolapse. Am J Obstet Gynecol. 1999 Jul;181(1):87–90.
Journal cover image

Published In

Am J Obstet Gynecol

DOI

ISSN

0002-9378

Publication Date

July 1999

Volume

181

Issue

1

Start / End Page

87 / 90

Location

United States

Related Subject Headings

  • Vaginal Diseases
  • Vagina
  • Sensitivity and Specificity
  • Retrospective Studies
  • Prolapse
  • Predictive Value of Tests
  • Palpation
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Medical Records