The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction,☆☆,

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Abstract

This article presents a standard system of terminology recently approved by the International Continence Society, the American Urogynecologic Society, and the Society of Gynecologic Surgeons for the description of female pelvic organ prolapse and pelvic floor dysfunction. An objective site-specific system for describing, quantitating, and staging pelvic support in women is included. It has been developed to enhance both clinical and academic communication regarding individual patients and populations of patients. Clinicians and researchers caring for women with pelvic organ prolapse and pelvic floor dysfunction are encouraged to learn and use the system. (Am J Obstet Gynecol 1996;175:10-7.)

Section snippets

DESCRIPTION OF PELVIC ORGAN PROLAPSE

The clinical description of pelvic floor anatomy is determined during the physical examination of the external genitalia and vaginal canal. The details of the examination technique are not dictated by this article, but authors should precisely describe the technique. Segments of the lower reproductive tract will replace such terms as “cystocele, rectocele, enterocele, or urethrovesical junction” because these terms may imply an unrealistic certainty as to the structures on the other side of the

ANCILLARY TECHNIQUES FOR DESCRIBING PELVIC ORGAN PROLAPSE

This series of procedures may help further characterize pelvic organ prolapse in an individual patient. They are considered ancillary either because they are not yet standardized or validated or because they are not universally available to all patients. Authors using these procedures should include the following information in their articles: (1) Describe the objective information they intended to generate and how it enhanced their ability to evaluate or treat prolapse. (2) Describe precisely

PELVIC FLOOR MUSCLE TESTING

Pelvic floor muscles are voluntarily controlled, but selective contraction and relaxation necessitates muscle awareness. Optimal squeezing technique involves contraction of the pelvic floor muscles without contraction of the abdominal wall muscles and without a Valsalva maneuver. Squeezing synergists are the intraurethral and anal sphincteric muscles. In normal voiding, defecation, and optimal abdominal-strain voiding, the pelvic floor is relaxed, whereas the abdominal wall and the diaphragm

DESCRIPTION OF FUNCTIONAL SYMPTOMS

Functional deficits caused by pelvic organ prolapse and pelvic floor dysfunction are not well characterized or absolutely established. There is a continuing need to develop, standardize, and validate various clinimetric scales such as condition-specific quality-of-life questionnaires for each of the four functional symptom groups thought to be related to pelvic organ prolapse.

Researchers in this area should try to use standardized and validated symptom scales whenever possible. They must always

Acknowledgements

We thank the following consultants who contributed to the development and revision of this article: W. Glenn Hurt, Bernard Schüssler, and L. Lewis Wall.

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There are more references available in the full text version of this article.

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From the International Continence Society Committee on Standardisation of Terminology, Subcommittee on Pelvic Organ Prolapse and Pelvic Floor Dysfunction, in collaboration with the American Urogynecologic Society and the Society of Gynecologic Surgeons.

☆☆

Reprint requests: Richard C. Bump, MD, Duke University Medical Center, Box 3609, Durham, NC 27710.

0002-9378/96 $5.00 + 0 6/1/72363

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