OP28.06: Pelvic organ descent and hiatal dimensions in Asian and Caucasian women with symptomatic pelvic organ prolapse

Abstract

Ethnicity may be a significant factor in the etiology of pelvic organ prolapse. Nulliparous Asians seem to have a smaller hiatus and less pelvic organ mobility than Caucasians. However, data in symptomatic women is limited. This study aims to compare pelvic organ mobility and hiatal dimensions of East Asians and Caucasians presenting with symptomatic pelvic organ prolapse. We undertook offline analysis of 4D ultrasound volume data obtained from women who presented to tertiary urogynecology clinics with symptomatic pelvic organ prolapse from 2011-12 in Hong Kong and 2015-16 in Sydney. Women with previous hysterectomy and/ or incontinence or prolapse surgery were excluded. Volume acquisition was performed using Voluson systems using an identical methodology. On post-processing, pelvic organ descent and hiatal dimensions were assessed on Valsalva manoeuvre. Levator muscle avulsion was assessed in volumes obtained on pelvic floor muscle contraction. A total of 431 datasets were reviewed: 225 of Asian and 206 of Caucasian women. Pelvic organ descent and hiatal dimensions are shown in table 1. Asian women seem more likely to present with bladder and uterine prolapse while rectocele is more prevalent in Caucasians. All hiatal dimensions on Valsalva were larger in Caucasian women. The prevalence of levator avulsion was similar in both groups (p=0.38). There were substantial differences in pelvic organ descent and hiatal dimensions between Asian and Caucasian women presenting with symptomatic prolapse, the most obvious being much higher uterine mobility in Asians.