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Int Urogynecol J. 2012 Apr;23(4):417-22. doi: 10.1007/s00192-011-1656-0. Epub 2012 Jan 26.

Does pre-operative traction on the cervix approximate intra-operative uterine prolapse? A randomised controlled trial.

Author information

1
Pelvic Floor Unit Southern Health, Monash Medical Centre, Moorabbin Campus, Melbourne, Victoria 3165, Australia. faylchao@yahoo.com.au

Abstract

INTRODUCTION AND HYPOTHESIS:

This study aims to compare pre-operative Pelvic Organ Prolapse Quantification (POP-Q) point C with and without cervical traction to that obtained intra-operatively in women undergoing pelvic organ prolapse surgery and to assess acceptability of examination with cervical traction without anaesthesia.

METHODS:

Eighty-one women were randomised to having pre-operative examination with or without cervical traction to measure point C. Visual analogue scale (VAS) pain scores were recorded for each pre-operative examination. Comparisons were made between pre-operative and intra-operative findings.

RESULTS:

The mean difference between pre-operative and intra-operative point C in the non-traction group was statistically higher than in the traction group (3.2 vs 1.6 cm, p = 0.0001). The level of agreement between pre-operative point C measurement with traction and intra-operative point C measurement was better than pre-operative point C measurement without traction and intra-operative point C measurement on Bland and Altman plots. Women having cervical traction reported significantly greater pain score on the VAS (3.4 vs. 1.2, p < 0.0001).

CONCLUSIONS:

Compared to routine pre-operative examination with Valsalva and cough manoeuvres only, pre-operative examination with cervical traction had better agreement with intra-operative point C findings. Although women reported greater pain score when examined with cervical traction, it was still a tolerable and acceptable examination without anaesthesia.

PMID:
22278714
DOI:
10.1007/s00192-011-1656-0
[Indexed for MEDLINE]

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