Methods At a tertiary urogynecologi

Methods At a tertiary urogynecological center, 735women with symptoms of lower urinary tract dysfunctionand prolapse were seen for interview, clinical examination, multi-channel urodynamics and ultrasound imaging,while supine and after voiding, for prolapse quantification. Women with multi-compartment prolapse, i.e. thosein whom no compartment was clearly dominant wereexcluded. Receiver–operator statistics were used to testpelvic organ descent as a predictor of prolapse symptoms.Results Mean age was 55.1 years, mean parity 2.8 (range,0–12). Symptoms of prolapse were reported by 188women (25.6%). Seventy-four showed a symptomaticmulti-compartment prolapse and were excluded, 56symptomatic women had cystoceles and 48 had rectoceles.Symptomatic cystoceles descended on average to 23.8 mmbelow the symphysis pubis and symptomatic rectocelesto 21.4 mm below the symphysis pubis. Descent wasstrongly associated with symptoms of prolapse (both,P < 0.001). Receiver–operating characteristics (ROC)statistics suggested a cut-off of 10 mm below thesymphysis pubis for cystocele, and 15 mm below thesymphysis pubis for rectocele. ROC curves were similarfor both compartments (area under the curve, 0.857 and0.821, respectively).