Is a “dragging sensation” a symptom of female pelvic organ prolapse?

Hans Peter Dietz, Candice Chatel, Ixora Kamisan @ Atan

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction and hypothesis: Pelvic organ prolapse (POP) commonly presents with a “vaginal lump or bulge” and/or a “dragging sensation.” The first symptom correlates strongly with clinical and imaging data. However, a “dragging sensation” may be less specific. Hence, we investigated the predictive value of both symptoms for POP. Methods: This was a retrospective study involving archived data sets of women seen between November 2013 and May 2014. All underwent a clinical interview, POPQ examination, and 4D translabial ultrasound (TLUS). The main outcome measure was organ descent on clinical examination and TLUS. Offline analysis for organ descent was undertaken blinded against all other data. Results: A total of 224 women were assessed. Mean age was 57 (23–84) years. Median parity was 3 (0–7). Ninety-three percent (n=208) were vaginally parous. Fifty-eight percent (n=129) complained of symptoms of prolapse: 49% (n=110) of a vaginal lump, 27% (n=61) of a dragging sensation. Clinically, mean point B anterior (Ba) was −0.86 (−3 to +7.5) cm, mean cervical station (C) was −4.1 (−9 to +8) cm, mean point B posterior (Bp) was −1.1 (−3 to +5) cm. On imaging, mean bladder, uterine, and rectal descent were −8.3 (−68.0 to 34) mm, +18.6 (−56.4 to 46.3) mm, and −5.3 (−39.8 to 36) mm respectively. On univariate analysis, both symptoms were strongly associated with objective prolapse clinically and on TLUS, with “vaginal lump” consistently the stronger predictor. Conclusions: The symptom of a “vaginal lump or bulge” was consistently a stronger predictor of objective POP than “dragging sensation.” This finding was insensitive to adjustments for potential confounders. However, a “dragging sensation” is clearly a symptom of prolapse.

Original languageEnglish
Pages (from-to)1-5
Number of pages5
JournalInternational Urogynecology Journal
DOIs
Publication statusAccepted/In press - 21 Jul 2017

Fingerprint

Pelvic Organ Prolapse
Prolapse
Parity
Urinary Bladder
Retrospective Studies
Outcome Assessment (Health Care)
Interviews

Keywords

  • Pelvic organ prolapse
  • Symptoms
  • Transperineal ultrasound

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Urology

Cite this

Is a “dragging sensation” a symptom of female pelvic organ prolapse? / Dietz, Hans Peter; Chatel, Candice; Kamisan @ Atan, Ixora.

In: International Urogynecology Journal, 21.07.2017, p. 1-5.

Research output: Contribution to journalArticle

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abstract = "Introduction and hypothesis: Pelvic organ prolapse (POP) commonly presents with a “vaginal lump or bulge” and/or a “dragging sensation.” The first symptom correlates strongly with clinical and imaging data. However, a “dragging sensation” may be less specific. Hence, we investigated the predictive value of both symptoms for POP. Methods: This was a retrospective study involving archived data sets of women seen between November 2013 and May 2014. All underwent a clinical interview, POPQ examination, and 4D translabial ultrasound (TLUS). The main outcome measure was organ descent on clinical examination and TLUS. Offline analysis for organ descent was undertaken blinded against all other data. Results: A total of 224 women were assessed. Mean age was 57 (23–84) years. Median parity was 3 (0–7). Ninety-three percent (n=208) were vaginally parous. Fifty-eight percent (n=129) complained of symptoms of prolapse: 49{\%} (n=110) of a vaginal lump, 27{\%} (n=61) of a dragging sensation. Clinically, mean point B anterior (Ba) was −0.86 (−3 to +7.5) cm, mean cervical station (C) was −4.1 (−9 to +8) cm, mean point B posterior (Bp) was −1.1 (−3 to +5) cm. On imaging, mean bladder, uterine, and rectal descent were −8.3 (−68.0 to 34) mm, +18.6 (−56.4 to 46.3) mm, and −5.3 (−39.8 to 36) mm respectively. On univariate analysis, both symptoms were strongly associated with objective prolapse clinically and on TLUS, with “vaginal lump” consistently the stronger predictor. Conclusions: The symptom of a “vaginal lump or bulge” was consistently a stronger predictor of objective POP than “dragging sensation.” This finding was insensitive to adjustments for potential confounders. However, a “dragging sensation” is clearly a symptom of prolapse.",
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